Nodular melanomas can be GROWING RAPIDLY and DARK, the ‘GRaD moles’ More rarely they can grow spontaneously as a nodule. NODULAR MELANOMAS occur at a later stage, especially if the early flat and dark lesions are not recognised. There is a possibility of spread but this is low. There is invasion of malignant melanocytes into the dermis, the thickness of the melanoma is less than 1-2mm. SUPERFICIAL SPREADING MELANOMA has also a SMOOTH surface and is usually DARK. ![]() ![]() Lentigo maligna occurs in the elderly on sun damaged skin, is slow growing with malignant cells seen in the epidermis only. The malignant cells are only in the outer layer of the skin (epidermis) so cannot spread anywhere else. In-SITU MELANOMA is a melanoma-in-waiting. Junctional cell throughout lesion, intradermal cell centrally only.Įarly melanoma has a SMOOTH surface and is usually DARK, a ‘SaD mole’, and scores 3+ points on the ABCD check list (see before). Naevus cells at dermo-epidermal junction and within the dermis. Naevus cells at dermo-epidermal junction. Raised (dome shaped or papillomatous) & skin coloured. These may change by getting LIGHTER and ELEVATED over time through 3 stages: a. (malignant melanoma) (malignant melanoma)īENIGN MOLES (present from childhood may also have a smooth surface) (A=Asymmetry not used = irregular shape or colour, A for area instead of diameter and D for dark) SCORE 2 to diagnose dysplastic naevus and SCORE 3+ to diagnose a melanoma. (this results in an increase in size/area, with an irregular border and irregularity in colour as well as becoming darker). The pigment cells in a melanoma start to spread outwards first in an irregular manner: ![]() If a mole is SMOOTH and DARK, then use the ABCD checklist. Seborrhoeic keratoses/warts also score using the ABCDE check list (asymmetry, border, colour, diameter, evolution) so the presence of these features does not necessarily mean the lesion is malignant.Ī DARK area in a mole with a SMOOTH surface is a more useful sign that the mole should beĮarly MELANOMAS are SMOOTH & DARK (the SaD mole) Richard Ashton Dermalogical Surgeon | Check your own mole, melanoma, skin cancer checkīENIGN ‘MOLES’ (*here I define a mole as any pigmented lesion seen on the skin) do CHANGE
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