Sunday, March 20, 2011

Melanoma's "Ugly Duckling" Appearance

Do you have your ducks in a row when it comes to scanning your body for skin cancer? You may be familiar with the ABCDE's of melanoma (Asymmetry, Border, Color, Diameter, Evolving), but do you know about the "Ugly Duckling" concept? I love this one, because it echoes what I often say to patients when they ask why a certain mole looks "suspicious"- I tell them it's like the old Sesame Street concept that "one of these things is not like the just doesn't belong"!

Like everything in medicine, each body has its own version of what we describe in textbooks. While diseases have a distinctive pattern, the actual specifics will vary from person to person. Along those lines, what we are looking for in melanoma is a mole that simply does not fit the PATTERN that your body has developed. For example, if you are covered in large brown moles, but you notice one small dark black one- it's that small one we worry about. If you have no moles at all except one medium light brown one, we worry about that medium-sized one, not because it is medium or brown, but because your "pattern" is NONE, and this is breaking that pattern. Make sense?

Here is a a graphic from the Skin Cancer Foundation that illustrates this concept. The arrows point to the odd man out, which is the mole that we would tend to prefer in a pathology lab than staying on your body.

BOTTOM LINE: Take a good look at your skin from top to bottom (use mirrors!) and learn to recognize the pattern of TYPES of moles that you have, so you will recognize that "ugly duckling" mole before it turns into full blown skin cancer!

1 comment:

Unknown said...


Thank you for taking the time to offer this brief (and calming) entry.

I have a suspicious mole on my outer right calf...about 1/2" in size, mildly irregular in shape, a bit scaly in appearance and with a tingling sensation. However, in all other respects the mole looks quite normal (uniform in color, and of identical color to every other mole on my body). Nevertheless, I am going to schedule an appointment with a dermatologist this coming week, just to be sure.

All I can say is, as an anxiety-prone individual, research online provided plenty of fodder for worry. Truth be told, I was becoming something of a tangled mess. But then I found your blog entry and it helped calm my fear. I realize I still need to get this evaluated as soon as possible, but knowing that the mole, although out of the ordinary, doesn't really strike me as an "ugly duckling" went a long way toward putting my anxiety to rest. Thank you. :-)

Take care,