dermatologic disorders
Atypical Moles
Diagnosis of Atypical Moles
Clinical evaluation Dermatoscopic evaluation Biopsy Regular physical examinations Atypical moles must be differentiated from melanoma. Features that suggest melanoma, known as the ABCDEs of melanoma, are A: Asymmetry—asymmetric appearance B: Borders—irregular borders (ie, not round or oval) C: Color—color variation within the mole, unusual colors, or a color significantly different or darker than the patient's other moles D: Diameter—>6 mm E: Evolution—a new mole in a patient>30 years of age or a changing mole Although clinical findings can sometimes establish a diagnosis of atypical moles (see table), visual differentiation between atypical nevi and melanoma can be difficult; biopsy of the worst-appearing lesions should be done to establish the diagnosis and to determine the degree of atypia. Biopsy should aim to include the complete depth and breadth of the lesion; excisional biopsy is ideal. Patients with multiple atypical moles and a personal or family history of melanoma should be examined regularly (eg, yearly for family history of melanoma, more often for personal history of melanoma). Some dermatologists observe pigment patterns of melanocytic lesions using a hand-held instrument known as a dermatoscope. Dermoscopy allows a dermatologist to see structures not visible to the naked eye. Dermoscopy can reveal certain high-risk characteristics suggestive of melanoma (eg, blue-white veil, irregular dots and globules, atypical pigment network, reverse network). 