Beware! Moles can be malignant!

A tiny mole on the chin can be a beauty spot while a large raised and hairy mole can be an eyesore. But moles don’t have just cosmetic significance. Though all moles are not dangerous, some, even if they’re painless, can be potentially.

Medical experts explain when to be wary about a mole and get tests done to rule out malignancy. The lighter the skin (due to less melanin, which is responsible for skin pigmentation), the more one is at risk of developing skin cancer, and changes in moles can be a vital indication, especially of the early stages of malignancy. With increased exposure to the sun’s ultraviolet rays, even Indians who are not light-skinned are no longer immune to skin cancers

‘Raised hairy moles are risky’

Radiation oncologist Dr N Sujatha, former head of the Department of Oncology, Andhra Medical College-King George Hospital (AMC-KGH) explains that “Cancerous moles (with abnormal melanocyte), are also called junction nevus because they proliferate at the junction of the dermis and epidermis (between the superficial and deeper layers of the skin). Initially, most of the moles are painless, but as the cancer progresses, they turn painful. With abnormal cell division occurring, the colour, shape and size of the moles change too.”

There are also some unesthetic-looking moles which are raised and hairy. “They may increase in size over a period of time. It is advisable to surgically remove these as they may be malignant,” adds Dr Sujatha.

ABCDE of malignancy

“There is a simple formula which can be remembered using the acronym ABCDE to identify potential malignancy. A (asymmetrical shape), B (border of the mole is uneven or poorly defined or crooked, C (Colour variation within the same mole), D (Diameter greater than six millimetre), E (Extension, expansion or evolution of the size of the mole). If the mole conforms to the above formula, it is a warning sign of cancer,” says Dr Sravya C Tipirneni, consultant dermatologist, cosmetologist and trichologist at Manipal Hospitals. “If there is bleeding, crusting or itching from the mole, then one must get a biopsy done,” she cautions.

Hutchinson’s sign

Another sign to watch for is the brown-black discolouration of the nail bed — that is, the pigmentation surrounding finger — and toe nails. If the skin around one or two nails extending to the cuticle turns black, it can be indicative of melanoma of the nail bed, warns Dr Sravya.

Types and tests

“If fair-skinned adults with genetic or family history of cancer get new moles, they should get them evaluated under a dermatoscope. Biopsy is the gold standard test for any unusual moles. While light-skinned Indians [mostly get Squamous Cell Carcinoma (BCC) and Basal Cell Carcinoma (BCC), white-skinned people get the melanoma category of skin cancer. BCC is found mostly in sun-exposed areas such as the forehead or the nose, and is fast-spreading,” adds Dr Sravya.