Self Skin Exam

July 18th, 2010

Patients peforming their own skin exams is very important in aiding the early detection of skin cancer.  I am frequently asked by patients what to look for when they examine their skin.  As there are many different types of skin cancer, which can have vastly different clinical appearances, it is very difficult to give a succinct answer.  Thus, I recommend a patient and their partner (husband/wife) examine each others skin very closely and form a mental image of what is currently present.  This should be done on a monthly basis.  If any new skin lesion occurs or a pre-existing lesion changes, an appointment should be made immediately with a board certified dermatologist to assess this lesion.  Essentially, skin cancer will exhibit change, either in occurring de novo or a pre-existing lesion growing or developing symptoms such as itching or bleeding.  In my opinion, a symptomatic lesion may be your body’s way of alerting you to a problem.  Moles have a mnemonic called the ABCDE’s of melanoma: A – Asymmetry (A benign mole should be evenly uniform.  If a line is drawn down the middle of the mole, both halves should look identical), B- Border (the outside rim of a mole should be smooth and circular. If it has the appearance of a jigsaw puzzle this is concerning), C- Color (The color should be uniform.  A light brown color is preferred and it should be homogenous throughout the mole.  Very black moles are concerning for melanoma as are small black dots arising in the mole which could be be a melanoma arising in a mole.  50% of all melanomas arise from a previously benign mole.  I almost always biopsy a mole that has a black dot within it.  The colors red and blue arising in a mole also are worrisome), D- Diameter (This is the weakest of the mnemonic as 38% of all melanomas are found under 6mm.  However, the mnemonic states that if a mole is over 6mm it is worrisome, which is the size of a pencil eraser.  I view “D” as if a mole is getting larger it is worrisome.  E- Evolution (This is by far the most important letter in the mnemonic as it is synonymous with change.  A changing mole must be seen as quickly as possible by a board certified dermatologist as a melanoma is going to be changing as it progresses and becomes more invasive).   Skin cancer can occur anywhere on the body so patients should examine every portion of their skin including their feet and toe webs.  Other common skin cancers to be aware of are basal cell cancer and squamous cell cancer.   These are typically in sun exposed areas.  Basal cell cancers have a pearly appearance and can spontaneously bleed.  Squamous cell cancers tend to be more crusty and scaly then basal cell cancers, however many times the features of both squamous cell cancer and basal cell cancer are interchangeable with each other.  Also, any non-healing wound is concerning for one of these skin cancers.  In summary, I urge patients to closely survey their skin and never hesitate to come in to be seen by me or another board certified dermatologist for a new or changing skin lesion.  In my practice, the office hours are very convenient with both evening and Saturday hours so a worrisome lesion does not have to wait to be seen.  The earlier a skin cancer is detected and treated the better the prognosis and cosmetic outcome.

Dr. Perri is a board certified dermatologist with offices in Conroe (Conroe dermatology – Conroe dermatologist) and The Woodlands (Woodlands dermatology – Woodlands dermatologist) offering extended weekday hours from 8AM to 8PM as well as Saturday hours in The Woodlands