DECEMBER 1998 MONTHLY NEWLETTER

Georgetown Health Care Center Georgetown Pharmacy

Patient education programs stessing the warning signs of cancer and increasing awareness of the dangers of melanomas have made great strides in getting people to visit their physicians to have their moles checked. Given that the most positive results in curing malignant melanoma are through early detection and treatment, these educational programs have been essential to the progress that has been made in this area.

A widely accepted tool to promote early detection of melanoma is the "ABCD" rule. This rule is Asymmetry, Border irregularity, Color variegation, and Diameter greater than 6 mm (about the size of a pencil eraser). Lesions that are asymmetrical (not balanced in appearance) are evaluated for color, shape, and whether they are flat or raised. When borders are irregular, it appears that there are finger-like extensions and the borders are not clearly distinguishable. Color variegation refers to a mottled or haphazard display of colors in the mole, with shades of brown, black, blue-gray, pink, and white. Any uniformly black lesions should be considered suspicious as well. It is useful to compare the size of any suspicious mole to that of others that are present. Given that melanomas are usually more than 6 mm in diameter, any mole that is larger than a pencil eraser should be evaluated.

However, the "ABCD" rule should not be relied upon solely for identifying dangerous skin lesions. The most significant features of eatly malignant melanoma are changes in a lesion's shape, size and color. Itching, bleeding, weeping, oozing, crusting, and recent appearance are useful conditions to note as well.

It has been suggested that the public should be educated that the "ABCD" rule should be amended by adding and E for Enlargement, Erythema (inflammation), or Elevation. A mole that enlarges, appears to be inflamed and has a rim of redness around it, or has become raised should be evaluated. A Physcian's clinical judgement is required because even harmless moles naturally change over the years from flat, small, brown lesions to raised, skin-colored lesions.

Any suspicious mole should be evaluated by your physician as quickly as possible. A prompt biopsy to confirm the diagnosis and excision if the mole is found to be harmful is the best treatment.