Have you ever been concerned about the moles on your body? You may have noticed that some moles are different from others, larger, different in color, and have no shape. That's what we're going to talk about today. We call these 'abnormal moles' or medically known as `(Dysplastic Nevus)`. Don't worry, we'll talk about this simply and in a way that you can understand.
What are these spots? What is the difference between normal spots and abnormal spots?
Okay, first let's look at what a mole is. There is a special type of cell that gives color to our skin, they are called melanocytes . Moles are formed when these melanocytes gather in one place. In medical terms, a mole is called a nevus . When there are many moles, they are called nevi .
Most people just have normal freckles . It's normal for an adult with fair skin to have about 40 freckles. Both these normal freckles and the abnormal freckles we're talking about today usually start appearing during childhood and adolescence.
Now let's see what a dysplastic nevus is, or an abnormal mole . Simply put, it's a mole that looks different from a normal mole. It may have irregular edges, mixed colors, and may appear larger than other moles.
The word 'dysplastic' means that there are abnormal cells in a tissue. This is also called dysplasia . But don't worry , these abnormal cells are not cancer, which means they are benign ( non-cancerous). However, sometimes they can become cancerous. That's why you need to be concerned about this.
How common are these unusual spots? Is there really a risk of developing cancer?
These unusual spots are more common than you might think. According to experts, one in ten Americans has at least one unusual spot. So, this condition can be seen in Sri Lanka to a greater or lesser extent.
Now the most important question: Does this `(Dysplastic Nevus)` cause skin cancer?
To be honest, yes, there is a risk. If you have these types of unusual spots, your risk of developing a serious type of skin cancer called melanoma is higher than the average person. The more unusual spots you have, the higher your risk of this cancer. Imagine, someone with 10 or more unusual spots is about twelve times more likely to develop melanoma.
But there is something else. Not everyone with unusual spots will develop ``(Melanoma)''. Keep that in mind too. So don't worry unnecessarily.
Experts say that about one in four cases of melanoma begins with a pre-existing dysplastic nevus, an abnormal mole.
What are other names for this `(Dysplastic Nevus)`?
When your doctor talks about this `(Dysplastic Nevus)`, you may also use these words:
- Atypical mole
- Clark's nevi
- Congenital nevus (this is a type of birthmark)
- Spitz nevus
Why do these unusual spots appear?
Experts still don't know exactly what causes it, but they believe it's a combination of genetic factors (meaning if someone in your family has them, you're more likely to get them too) and environmental factors (especially exposure to ultraviolet (UV) light from the sun) .
What are the pathways through which this ultraviolet light comes?
We all know that the sun is the main natural source of `(UV)` rays. In addition, `(UV)` rays are artificially produced by:
- Some halogen, incandescent, and fluorescent lights, as well as some laser beams.
- Mercury vapor lighting is used in large spaces like stadiums and gyms.
- Tanning beds and sunlamps. You should definitely stay away from these.
Who is at higher risk of developing these unusual spots?
In fact, anyone can develop these unusual spots, regardless of age, gender, or skin color. Having dark skin does not completely protect you from developing these spots or skin cancer. But the risk can be reduced to some extent.
People with the following characteristics are more likely to develop unusual spots:
- Very fair skin, freckles, and light-colored eyes and hair.
- If anyone in the family has unusual moles, skin cancer, or melanoma.
- If you have a history of excessive sun exposure and sunburns, or if you have an inability to tan (meaning your skin turns red but not black when exposed to the sun).
- If you have photosensitivity to UV rays.
How do you recognize this unusual spot? What are its characteristics?
An abnormal mole (Dysplastic Nevus) may have one or more of these characteristics. To help you remember these, there is a rule called the ABCDE rule . Let's understand it in Sinhala:
- A - Asymmetrical shape: If the mole is divided in half, it is an abnormal feature if it is not the same on both sides, meaning one side is different from the other. A normal mole is mostly symmetrical, meaning it is round or oval in shape.
- B - Borders that are irregular: If the edges of the mole are unclear, blurry, or rough, jagged, like a coastline on a map, that is also a sign to look for. The edges of normal moles are often smooth and clear.
- C - Colors: If the mole is not a single color, but has one or more colors mixed together, such as pink, red, light brown, dark brown, or black, it is also suspicious. Sometimes it can even look like a blue color. A normal mole is often a single brown color.
- D - Size (Diameter): If the mole is larger than the size of a pencil eraser (about 1/4 inch, or about 6 millimeters), pay attention to that as well. However, some abnormal moles can be smaller than this. Also, some normal moles can be larger than this. Therefore, you cannot decide based on size alone, you need to look at it along with other characteristics.
- E - Evolving: If the size, shape, or color of the mole changes over time, or if the mole bleeds, itches, is painful, or changes in surface (e.g., a smooth mole becomes rough), that is also something that should definitely be taken into consideration.
Additionally, an abnormal spot may have a flat, pebbly appearance, or may be slightly raised on the surface.
Where on the body are these unusual spots most common?
These unusual spots can actually appear anywhere on your body, but they are most commonly seen on:
- In the trunk area (i.e. chest, stomach, back)
- And the extremities of the arms and legs
- In the head
- Neck
- Scalp (These can be missed because they are behind the hair, so use a mirror or have someone else check them.)
What other complications can occur due to this `(Dysplastic Nevi)`?
In addition to the risk of melanoma, if you have a lot of unusual spots, you are also at risk of developing eye cancer (ocular melanoma) . Therefore, you will need to have regular eye exams.
How do doctors identify these abnormal spots (Dysplastic Nevi)?
If you suspect you have unusual spots, it's best to see a dermatologist, a doctor who specializes in skin diseases. They are the ones who can accurately diagnose and treat conditions like skin diseases and skin cancer.
Your doctor may do tests like these:
- Skin examinations: Once or twice a year, your moles will be checked for changes. If someone in your family has had melanoma, you may be asked to have these examinations every three to six months.
- Dermoscopy: This involves using a special magnifying instrument called a dermatoscope to look for abnormalities in the mole that are not visible to the naked eye. It is like looking at a mole through a microscope. This allows you to see the subtle patterns and colors of the mole clearly.
- Mole mapping: This involves using a special camera (also known as a dermatoscopic lens) to create a computerized map of your skin and moles. This makes it easy to compare moles over time to see if they have changed. This is especially useful for people with a lot of moles.
Can you recognize unusual changes in spots?
You can definitely do it! It's important to do regular skin self-exams . If you have unusual spots or other risk factors for skin cancer, doctors recommend checking your skin at least once a month . You can also take photos and keep them so you can see any changes month after month.
When checking for spots, remember the ABCDE rule we talked about earlier.
- A (Asymmetrical): Is the shape asymmetrical?
- B (Border): Are the edges irregular or blurred?
- C (Color): Is more than one color mixed?
- D (Diameter): Is the size larger than a pencil eraser (more than 6 mm)?
- E (Evolving): Is the spot getting bigger, changing shape, or color over time? Is there itching, bleeding, or pain?
If you notice anything unusual, don't just assume, "This is just a fluke," and see a doctor right away. Even if it's a minor thing, it's always best to get it checked out.
How do you treat these unusual spots?
Usually, an abnormal mole does not require any special treatment, unless a skin biopsy (a test that takes a piece of skin) confirms that it is cancerous or has pre-cancerous changes. If your doctor says the biopsy is atypical melanocytic hyperplasia or moderately to severely dysplastic , this means that the risk of cancer is high. In that case, your doctor will treat the mole with another surgery.
The treatment for abnormal moles is to surgically remove the mole and a small amount of healthy skin around it. If the biopsy confirms that the abnormal mole is cancerous (melanoma), your doctor may perform a larger operation, or they may use a procedure called Mohs surgery . This procedure preserves as much healthy tissue as possible.
Can I prevent the appearance of abnormal spots? How can I protect myself from the sun?
Although having abnormal moles increases the risk of melanoma, simply removing normal moles does not reduce this risk.
There's really nothing you can do to completely prevent the appearance of abnormal spots, as there's also a genetic factor. But if you have them, it's important to protect your skin from sun damage. Also, never use tanning beds.
Do these things to protect your skin from the sun:
- Minimize going out during peak hours (usually 10 am to 4 pm) as much as possible.
- If you go outside, wear a wide-brimmed hat, long-sleeved clothing, and sunglasses.
- Be sure to use a sunscreen with an SPF of 30 or higher . Apply 15-30 minutes before going outside. Reapply every two hours if you sweat, get wet, or get sunburned.
- Avoid exposing infants (under 6 months) to direct sunlight as much as possible.
What is the health status of someone with `(Dysplastic Nevus)`?
Many people have unusual spots (and even normal spots) but they don't develop skin cancer. However, it's important to check your skin regularly for any unusual changes. Early detection and treatment of a condition like melanoma can save lives. So it's important to be aware and not panic.
What is 'Atypical Mole Syndrome'?
People with atypical mole syndrome have a large number of moles and are at increased risk of developing melanoma. While most of these moles are normal, some are abnormal. Some moles can be larger than a third of an inch (about 8 mm).
A different condition is called Familial Atypical Multiple Mole Melanoma (FAMMM syndrome) . This affects members of the same family. An inherited gene mutation increases the risk of developing atypical moles and melanoma. People with FAMMM syndrome are about 25 times more likely to develop melanoma.
Finally, this is what I have to say to you (Take-Home Message)
Many people have unusual moles, but they never develop melanoma. But if you have unusual moles, called dysplastic nevi, make it a habit to regularly check your skin (skin self-exams). This way, you can spot any changes quickly. Your doctor can teach you how to do these self-exams and tell you what changes to watch out for. They may also tell you to come in for regular checkups, and have your eyes checked. If you notice any changes in your skin, see your doctor right away. Early detection is key. Don't panic, it's wise to be aware. Take care of your skin, stay healthy!
` Freckles, Abnormal Spots, Dysplastic Nevus, Skin Cancer, Melanoma, Skin Health, Sunlight
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