SPOT WARNING SIGNS (THE ABC'S)
The "ABCD" rule and Melanoma Danger Signs
Finding melanoma early is the key to curing this vicious cancer. Learn the ABCD mnemonic for recognizing moles and growths that might be cancerous. Though most (if not all) of your "suspicious" moles will turn out to be normal non-cancerous moles, it is much better to be safe than to not see, or ignore, an early melanoma. Be sure to review how to do a monthly skin examination to properly look for abnormal growths.
If your mole or growth has one or more of the ABCDEs, you should show it to your physician as soon as possible!

Asymmetry
Asymmetry can be assessed by comparing one half of the growth to the other half to determine if the halves are equal in size. Unequal or asymmetric moles are suspicious.

Symmetric (normal)	Asymmetric

Border
If the mole's border is irregular, notched, scalloped, or indistinct, it is more likely to be cancerous (or precancerous) and is thus suspicious.

Regular Border (normal)	Irregular Border

Color
Variation of color (e.g., more than one color or shade) within a mole is a suspicious finding. Different shades of browns, blues, reds, whites, and blacks are all concerning.

One Color (normal)	Color Variance

Diameter
Any mole that has a diameter larger than a pencil's eraser in size (> 6 mm) should be considered suspicious.

Elevation/Enlargement
If a mole is enlarging, especially in height from skin surface (vertically) or laterally across the skin (horizontally), it should be examined immediately.

Other Danger Signs of Malignant Melanoma
• Change in color, especially multiple shades of dark brown or black; red, white and blue,
• Change or spreading of color from the edge of the mole into surrounding skin.
• Change in size, especially sudden or continuous enlargement.
• Change in shape, especially development of irregular margins or border.
• Change in elevation, especially sudden elevation of a previously flat mole.
• Change in the surface texture of a mole, especially scaliness, erosion, oozing, crusting, ulceration, or bleeding.
• Change in the the surrounding skin, especially redness, swelling, or new moles.
• Change in sensation, especially itching, tenderness, or pain.

Basically, any mole or growth that is CHANGING needs to be checked by a doctor.

A special note of caution should be mentioned for nodular melanoma (the second most common type).  Nodular melanoma often doesn't follow the normal ABC's.  Instead, Dr. John Kelly has suggested that it follows EFG's (see below), it is often smaller in size, symmetrical in shape, and even in color.  This is of particular importance since nodular melanoma has a rapid vertical growth phase and spreads quickly.

What are we looking for in early NM?*

• Small diameter
• Symmetrical
• Raised
• Often Pink or Red
• Even in color
• Firm to palpation
• Short history of change – one to several months

Nodular Melanoma: The EFG’s

• E – Elevated
• F – Firm to touch
• G – Growing progressively over more than a month

*John Kelly, MD, Head of the Dermatology Unit, Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia. See Dr. Kelly's article, "Nodular Melanoma: How Current Approaches to Early Detection Are Failing," in Vol. 22, No. 2, 2004 of The Skin Cancer Foundation's quarterly clinical publication, The Melanoma Letter.