NCCN Guidelines for Patients® | Melanoma

13 NCCN Guidelines for Patients ® : Melanoma, 2018 1  Melanoma basics Signs and symptoms Skin self-exam: A mole that changes is very important You should learn about the differences between normal and abnormal pigmented spots or lesions on the skin. The “ugly duckling rule” and the “ABCDE rule” are easy ways to remember how to tell a normal mole or spot (lesion) apart from a melanoma. Normal moles tend to have an even tan, brown, or black color. Most normal moles are less than ¼ inch in size—about the width of a pencil eraser. However, normal moles may be larger than ¼ inch and some melanomas are smaller than ¼ inch. Normal moles are round or oval and can be either flat or raised. They stay the same size, shape, and color for many years. Later in life, they often fade away. In contrast, melanoma often presents as a spot that does not “match” a person’s other moles. Or, it may cause an existing mole to change size, shape, or color. Itching, scaling, oozing, bleeding, redness, swelling, and tenderness are also possible but less common signs of melanoma. You should check your skin on a regular basis to recognize abnormal spots from normal ones. Use a full-length mirror and a hand-held mirror for areas that are hard to see. A partner may be able to help. Inspect all areas of your body. Remember, change in any spot (lesion) on your skin is an important sign. Know your skin so you can tell if there are any changes in existing spots or new areas of concern. Be sure to show your doctor any spots that have changed or that concern you. See Figure 6 on page 14. Figure 5 Superficial spreading melanoma Superficial spreading melanoma is the most common type of melanoma. Melanoma courtesy of the National Cancer Institute available at: