Dr. Geller has extensive experience and expertise in diagnosing and treating malignant melanoma, basal cell carcinoma, squamous cell carcinoma, and precancerous lesions.
He screens patients from their head to their toes to identify any moles or growths that might be of concern. He looks for any nevi, which are lesions such as birthmarks or beauty spots, which show atypical features. These might be raised or flat, dark or with mottled pigment, or with uneven or blurred borders. In most cases, they are benign, but they are evaluated against five main criteria–the ABCDEs (see below) – to determine whether further action is required.
The number of moles can also have a direct bearing on how innocuous they are, as can your family history. If after scrutiny there is a possibility that a mole could be dangerous, Dr. Geller will recommend a simple skin biopsy. This can usually be done during your visit, so that your wait for a diagnosis is kept to a minimum. The procedure usually only requires an injection of local anesthetic.
The alphabet of diagnosing skin moles
When examining skin moles, Dermatologists check for the ABCDEs of pigmented lesions. These are:
Asymmetry–does the mole have an uneven shape or texture?
Border–whether the edges are ragged or have altered.
Color–is the mole one color, or does it have patches or spots that are lighter or darker? Is it very dark?
Diameter–how big is it?
Evolving–whether the mole has grown or changed in some way.
Don’t ignore your Skin Moles.
Atypical Nevi Moles and Melanoma
What makes a mole “atypical” and what exactly does that mean?
Are atypical nevi precursors to melanoma?
Atypical nevi can be flat or raised, are darkly or irregularly pigmented, and usually have irregular or indistinct borders. Many studies have established that irrespective of histology, melanoma risk is directly related to numbers of ordinary nevi (>50 or 100 on the total skin surface) as well as the presence and number of atypical nevi. At present, melanoma risk assessment of patients is based upon the total number of nevi on the skin surface and the presence and number of clinically atypical nevi, along with other factors such as personal or family history of melanoma (Bolognia 1732). According to James et al, “atypical moles are associated with an increased risk of melanoma, which may be as much as one hundred fifty-fold greater than that of the general population. Familial atypical moles with inherited melanoma confer five hundred-fold greater risk. The lesions appear to be precursors for melanoma as well as serving as a marker for an increased risk of de novo melanoma” (James, Berger, Elston 693). Overall, there is no steadfast rule on which moles need to come off versus monitor. We consider many different factors: personal and family history, asymmetry, border, color, diameter, and any changes (“evolution”) or symptoms that develop. The latter factors are called the ABCDEs. In addition to regular skin checks – at least annually – everyone should check his or her moles monthly for these characteristics.
Bolognia, Jean L. MD; Jorizzo, Joseph L. MD; Ropini, Ronald P. MD. Dermatology. 2nd ed. Mosby Elsevier, 2008. 1732, 1760. Print.
Habif, Thomas, MD. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Mosby 2010, 856, 875-6. Print.
William D. James, Timothy G. Berger, Dirk M. Elston, Andrews Diseases of the Skin, Dermatology, 10th edition, (Saunders Elsevier 2006), page 693.