Dysplastic Moles
I have read that dysplastic moles are moles that have an irregular shape and border. I understand that this type of appearance can also be one of the early signs of melanoma. Are dysplastic moles worrisome? Myself and my daughter both have one. She developed hers as a child, and I developed mine ten years ago while I was pregnant.
Jennifer , Cincinnati, OHIO
2007-10-23

This is an excellent question because it brings up something that most of us are concerned about, namely what moles are considered normal and abnormal, and most importantly, what are the signs of melanoma that can help us in early detection.

Moles, referred to in my world as nevi, can come in a variety of sizes and colors, ranging from small flat brown ones to larger tan or pink raised ones.  They can occur anywhere on the body, including your scalp, feet and hands, and some moles can even disappear over time. 

I am often asked the question, “What is a mole, and how did I get it?”  Simply stated, moles are clusters of melanocytes (pigment producing cells) found in the top 2 layers of your skin.  You may be born with a mole, otherwise referred to as a congenital nevus, but most people develop their quota of moles by their early 20’s. Moles can change during periods of hormone adjustment such as adolescence and pregnancy.

 Who needs to get their moles checked and how often?  I think everyone should have an initial skin exam, and go over what they should be looking for with their dermatologist.  Your dermatologist can then better assess how often you need a full body exam based on the type and number of moles you have.

So how do you know what to look for, especially if moles can be so different? The first step is to be aware and comfortable with the moles you have on your body.  Make it a habit to check your body once a month.  Have someone else look at your back, ears and scalp since these aren’t areas that you can easily evaluate. I even tell people to take digital pictures and compare them side by side.  By using self-exams you can more quickly tell if a mole has changed and if it needs to be evaluated further.  

The standard criteria used to evaluate moles are the ABCDE’s of melanoma.

Moles that do not fit these criteria should be evaluated by your doctor. Any mole that suddenly changes shape, size or color should be evaluated.  Moles that itch, burn, bleed, or crust over should be evaluated. If you have a mole that has suddenly appeared past the age of 20, you should have that evaluated as well.

Are some people or some moles more at risk than others for developing melanoma?  People who are born with large, greater than 5 cm, congenital nevi are at increased risk and should be followed closely.  Some people have “dysplastic nevi” or atypical moles.  These hereditary moles tend to be larger than 6 mm in diameter, and have darker centers with lighter uneven borders creating a “fried egg” appearance. They are commonly found on the trunk, arms and legs.  Children as well as adults can have them, and although unusual, melanomas have been diagnosed in teenagers.  People with dysplastic nevi do carry an increased risk of developing malignant melanoma, and should be followed closely.  People with a positive family history of melanoma or with multiple moles are also at increased risk and should also have regular skin exams.
The bottom line- if you have any question regarding your moles, have them evaluated.  Early detection of melanoma makes a tremendous impact on long-term survival, and the hour you spend at your doctor’s office may be well spent.