The ABCs of Melanoma

If you’ve spent any time looking at my blog, you’ll notice that I harp on sunscreen. While I freely admit that I don’t do a good job of it when I am living my day to day life, I do a lot better when I’m on vacation in sunny spots.

Detail, beach, Curacao 2010

You all know that I am a big fan of sunscreen for two reasons. First, the sun ages you and I want everybody to look their best. Second, UV light can cause skin cancer. I’ve previously reviewed the basics of skin cancer. We talked about how it comes in different flavors- mainly basal cell carcinoma and squamous cell carcinoma. But I didn’t really talk about the baddie- Malignant Melanoma. That’s today’s topic.

Melanoma arises from the cells that make pigment in your skin. When we’re looking at pigmented skin lesions, there are some ways that we can differentiate bad ones from not bad ones. Here are the ABCs of Melanoma:

Not Melanoma




Non-cancerous pigmented lesions (from here on we’re going to call them nevi) are nice and round. Melanoma tends to be asymmetrical.


Nevi have nice smooth edges. Melanoma tends to have very irregular borders


Nevi tend to be uniform in color. Darker color, as long as it’s uniform, isn’t necessarily a problem. Melanoma lesions tend to not be uniform- they may have patches of brown, patches of black, or even patches of blue.


Melanomas tend to be larger than nevi. The nevus above is 3.5 mm wide. The melanoma lesion is about 15 mm wide. Melanomas tend to be larger than 6 mm.

Most importantly, if a pigmented lesion is changing, that is the most concerning thing. If someone came to me with a pigmented lesion that is changing, even if it’s small and uniform, I’m much more likely to do something about it than if it has been stable for years.

The melanoma pictured above grew up over several months. The patient ignored it while it was spreading out. More importantly, while it was growing out it was growing down into the skin. And then it really started acting badly.

Those tumor cells started going nuts- all those little dark lesions are called “satellite lesions” meaning they’re nests of melanoma that are left as it spreads through the skin. You really don’t want this.

If you’re concerned about a skin lesion, give us a call and let us check. Or go to your friendly neighborhood dermatologist. In the meanwhile, remember your ABCs!

To see before and after photos of patients who have had their skin cancers removed by Dr. Schmidt, click here!

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