Q: My dermatologist said that the spots on my arm are pigmented lesions and not to worry. Can these lesions become cancerous?

A: "Pigmented lesion" is a general term that includes normal moles, sun freckles or age spots (lentigines). While most pigmented lesions will not become cancerous, a person with many lesions or unusual lesions should see a dermatologist on regular basis for a full skin examination. Regular monitoring allows the dermatologist to identify changes in lesions that look "suspicious." A change may prompt a skin biopsy (examination of tissue from the mole), which can help determine whether a lesion is non-cancerous (benign), melanoma or another type of skin cancer.

Q: What sort of changes in my moles should I watch for?

A: There are several key signs to watch for and you can remember them by using the mnemonic "ABCDE":

  • Asymmetry the shape of one-half of the mole doesn’t match the other
  • Border mole edges are ragged and blurred
  • Color a mole exhibits uneven shades of brown, black or tan, and sometimes patches of red, blue, or white
  • Diameter the width of the mole is greater than one-quarter inch (e.g., the size of a pencil eraser, although some melanomas may be smaller)
  • Elevation a mole appears elevated, or raised from the skin levation a mole appears elevated, or raised from the skin levation a mole appears elevated, or raised from the skin levation a mole appears elevated, or raised from the skin symmetry the shape of one-half of the mole doesn’t match the other

Q: Do moles change during pregnancy?

A: During pregnancy, moles often change evenly due to hormonal effects. For example, they may darken or become larger. However, if a mole changes in an irregular or uneven manner, have it evaluated by a dermatologist.

Q: I just noticed a new mole. What should I do?

A: A new mole should always be regarded as suspicious. Seek prompt consultation with a dermatologist so that a thorough history, examination and skin biopsy (if appropriate) can be performed. If the lesion is a melanoma, a biopsy can show how deeply it has penetrated the skin. This measurement is critical in predicting the statistical survival rate after removal of the tumor and in directing the need for any additional therapy.

Q: What are the risk factors for melanoma?

A: Risk factors for melanoma include a personal history of many moles (more than 25), large moles (larger than 6 mm or the size of a pencil eraser), atypical or unusual looking moles, fair skin, light eye or hair color, family history of melanoma, intense sun exposure with blistering sunburns as a child or adult, tanning salon usage and sun sensitivity.If you have risk factors for melanoma, minimize your risk by protecting your skin from the sun, performing self-skin examinations and having regular follow-up visits with a dermatologist.

Q: I’ve heard about a melanoma vaccine. Is it available to the public?

A: Unlike most vaccines, which are given to prevent communicable diseases like measles or chicken pox, the melanoma vaccine is designed for patients with advanced stage melanoma. Following surgery, patients are given the vaccine to boost their immune system’s defense against any residual cancer cells in the body. The vaccines are still experimental and have not been approved by the FDA.

Clinical trials using vaccines and other forms of biologic therapy, including interferon, cytokines and monoclonal antibodies, are ongoing. At the Cleveland Clinic Taussig Cancer Center, a weekly Melanoma Clinic is held, where specialists in dermatology, oncologic surgery, oncology and pathology can evaluate patients.

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