Clinical Signs and Symptoms of Melanoma: The ABCDE's: By David Robles, MD, PhD






Clinical Signs and Symptoms of Melanoma

Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Some people watch a mole change and delay going to the doctor to get it checked out. This is NEVER a good idea because if caught very early melanoma has a high cure rate.

-The most common early signs of melanoma are: 

A growing mole on your skin.
-Unusual looking mole on your skin or a mole that does not look like any other mole on your skin (the “ugly duckling”).
-Non-uniform mole (has an odd shape, uneven or uncertain border, different colors).

Melanoma may not cause any symptoms. But sometimes melanoma will: 

-Itch.
-Bleed.
-Feel painful.

ABCDE’s of Melanoma. These very simplified characteristics are used to teach patients what to look for when checking for melanoma. It is important to note, that this is just a simplification, since not all melanomas have these features. Look for these signs: Asymmetry, irregular Borders, uneven Color, or a large Diameter (larger than a pencil eraser). E is for evolution or change in your moles - know what's normal for your skin and check it regularly for changes. If you see these changes in your moles, make an appointment with a dermatologist immediately. 

A - Asymmetrical Shape
Melanoma lesions are often irregular, or not symmetrical, in shape. Benign moles are usually symmetrical.

B - Border
Melanoma lesions usually have irregular borders or edges. Non-cancerous moles usually have smooth, even borders.

C - Color
Multiple colors or uneven distribution of color can sometimes be a warning sign of melanoma. Benign moles are usually uniform in color.

D - Diameter
Melanomas are often (but not always) greater than 6 millimeters in diameter (roughly the size of a pencil eraser).

E - Evolution
Perhaps the most important factor to consider, is change or evolution of a mole. This is why its important for you to know your moles well. Change can be in any of the parameters discussed above; size, color, borders, shape. Take pictures of your moles, store them on your phone or computer with the date of when you took them. See your dermatologist, if you have changing moles.


Not all melanomas come from a pre-existing mole. In fact, a study of 1,048 melanoma patients found that 70 to 80% of melanomas start in previously normal skin, where there was no pre-existing mole. That means only 20 to 30% melanomas come from a changing mole! 


Did you know that not all melanomas are dark black like the images in brochures? Amelanotic literally means "without melanin", and some melanomas, like the one in this picture, have little or no pigment. If you have a new or changing skin lesion get it checked out by your dermatologist. One visit can save your life. 

Amelanotic Melanoma


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