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Melanoma: Signs and symptoms


What are the signs and symptoms of melanoma?

Melanoma is a skin cancer that can show up on the skin in many ways. It can look like a:

  • Changing mole

  • Spot that looks like a new mole, freckle, or age spot, but it looks different from the others on your skin

  • Spot that has a jagged border, more than one color, and is growing

  • Dome-shaped growth that feels firm and may look like a sore, which may bleed

  • Dark-brown or black vertical line beneath a fingernail or toenail

  • Band of darker skin around a fingernail or toenail

  • Slowly growing patch of thick skin that looks like a scar

Early melanoma

This early melanoma could be mistaken for a mole, so it’s important to look carefully at the spots on your skin.

The ABCDEs of melanoma

To help people find a possible melanoma on their skin, dermatologists created the ABCDEs of melanoma:

Public>Diseases>Skin-cancer>Types>Melanoma>Symptoms>Asymmetry
A = Asymmetrical shape
If you could fold the spot in half, the sides would not match.
Public>Diseases>Skin-cancer>Types>Melanoma>Symptoms>Border
B = Uneven border
Moles tend to have a smooth, even border. By contrast, melanoma tends to have a jagged (or uneven) border.
Public>Diseases>Skin-cancer>Types>Melanoma>Symptoms>Color
C = Color
Is varied from one area to another; has shades of tan, brown or black, or is sometimes white, red, or blue.
Public>Diseases>Skin-cancer>Types>Melanoma>Symptoms>Diameter
D = Diameter
Melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.
Public>Diseases>Skin-cancer>Types>Melanoma>Symptoms>Evolving
E = Evolving
 A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

If you find a spot on your skin that has any of the ABCDEs of melanoma, see a board-certified dermatologist for a skin exam. The following pictures can help you see how the ABCDEs of melanoma can appear on the skin.

Pictures of melanoma

How many of the ABCDEs can you find in the following pictures of melanoma?

Melanoma that looks like an odd-shaped mole

Would you mistake these melanomas for odd-shaped moles?

Both show the A (asymmetrical shape) and B (border uneven) of melanoma. The melanoma on the right shows the C (color varies).

Melanoma that looks like a sore

Melanoma often contains shades of brown, black, or tan, but some can be red or pink, such as the one shown here.

Still you can see some of the ABCDEs here. The spot shows the A (asymmetrical shape) and B (uneven border).

Melanoma that looks like a firm, raised growth

Melanoma can spread out as it grows, but this one is growing up and looks like a firm, raised growth.

Did you notice the A (asymmetrical shape) and B (uneven border)?

Melanoma that looks like an age spot

This melanoma is spreading out as it grows.

Did you notice the A (asymmetrical shape), B (uneven border), C (color varies), and D (diameter is bigger than a pencil eraser)?

Melanomas that could be mistaken for a common skin problem

Melanoma that looks like a bruise

Melanoma can develop anywhere on the skin, including the bottom of the foot, where it can look like a bruise as shown here.

Melanoma that looks like a cyst

This reddish nodule looks a lot like a cyst, but testing proved that it was a melanoma.

Dark spot

In people of African descent, melanoma tends to develop on the palm, bottom of the foot, or under or around a nail.

Did you spot the asymmetry, uneven border, varied color, and diameter larger than that of a pencil eraser?

Dark line beneath a nail

Melanoma can develop under a fingernail or toenail, looking like a brown line as shown here.

While this line is thin, some are much thicker. The lines can also be much darker.

Does melanoma hurt?

You can have melanoma without feeling any pain or discomfort. For many people, the only sign of this skin cancer is a spot that has some of the ABCDEs of melanoma or a line beneath a nail.

Sometimes, melanoma causes discomfort. It can:

  • Itch

  • Be painful

  • Bleed

How do people find signs of melanoma on their own skin?

Performing a skin self-exam as often as recommended by your dermatologist is the best way. While examining your skin, you want to look for the following:

  • Mole (or other spot on your skin) that is changing in any way

  • Spot that looks different from the rest of the spots on your skin

  • Growth or spot on your skin that itches, bleeds, or is painful

  • Band of color beneath or around a nail

  • Sore that doesn’t heal or heals and returns

The ABCDEs of melanoma can help you find changes to a mole, freckle, or other spot on your skin.

Tools that can help you find melanoma on your skin

To help you find melanoma early, the American Academy of Dermatology developed the following:

How to do a skin self-exam
This short video shows you how you can examine your skin for signs of skin cancer.

Body mole map
Use this diagram to draw the moles and other spots on your skin so that you can spot a change early.

Quiz: Could you spot a melanoma on your child’s skin?
Melanoma can look different on a child’s skin. Taking this short quiz can help you hone your skills at finding childhood melanoma.


Images
1,3,4,5,6,7,8: Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

2: Developed by the American Academy of Dermatology

9: Used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol 2006;55:741-60.)

10: Used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol 2018;78:479-89.)

References
Barnhill RL, Mihm MC, et al. “Malignant melanoma.” In: Nouri K, et al. Skin Cancer. McGraw Hill Medical, China, 2008: 140-167.

Gloster HM Jr, Neal K. “Skin cancer in skin of color.” J Am Acad Dermatol 2006;55:741-60.

National Comprehensive Cancer Network. “NCCN guidelines for patients: Melanoma.” 2018. Last accessed February 12, 2019.

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