Search for tag: "moles"

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Interviewer: This is actually from several listeners with describing in detail their moles. Some have different colors, some have different shapes, some are in weird places. The basic question is, should I get this checked? What should we be looking for, and when should we go to a dermatologist?

Dr. Smart: That's a great question. I think a lot of people struggle with this because sometimes you'll go into your dermatologist, he'll look at it for two seconds, and say, "Nothing to worry about. What are you doing here?" Or that's how you feel, but you're still doing the right thing.

That's why dermatologists go to medical school, and years of training because sometimes it does take years of training to be able to identify that is nothing to worry about, and this, this one is. But unless you spend that five seconds in front of a dermatologist, you will never know. So any time, you're really noticing a mole or a spot that's growing or changing to the point where you are noticing it, then it's legitimate to have that chat.

Now if it's something that's been present for many, many years of your life, and it's changing very minimally, the chance that, that's something truly concerning is exceedingly low, nevertheless, it can be. So whenever you are noticing something like that, there's never a wrong answer, there's never a time when you should say, "Oh, I shouldn't go to my dermatologist for this because you don't know.

Interviewer: So you're saying if it's growing in size, if it's something that you notice, what about color, place?

Dr. Smart: The very classic things that every dermatologist will tell you this, there's the A, B, C, D, E's of growing and changing lesions. And A is asymmetry, B is border, C is color, D is diameter, and E is evolution. So if any of those things are happening to any given spot, if one side is getting bigger than the other, or its starting to get little projections, so that it's not symmetric, that's concerning. If the border is starting to become funny rather than smooth, then that's a possible issue.

If the color is changing. It used to be tan, used to be just this normal beige, and now all of a sudden now there's a little bit of red, and a little bit of dark brown, well that's an issue too. And then diameter, if it's getting past a certain size, or measurements, so if it's getting big then that's something to change. And evolution is just thrown in there just for a cover-all. If it's changing, then come get it looked at. But I think it's really simple, if something's concerning you, then there's no reason to lose sleep over it. It's easy to come get it checked out.

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Interviewer: What exactly is mole mapping, and what can it do for you? We'll explore that next on The Scope.

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Interviewer: Dr. Doug Grossman is an expert in early diagnosis and treatment of skin cancers at Huntsman Cancer Institute and also head of the Mole Mapping Program. That name intrigues me. What is mole mapping?

Dr. Grossman: This is a unique program that we've offered at the Huntsman Cancer Institute for the past ten years, and essentially it involves taking full-body photographs of your skin. This is for patients who are at high risk for melanoma. Either they've had melanoma, it runs in their family, or they have lots of moles or what we call atypical moles. The most sensitive indicator for early melanoma is a change. The only way we can know that a lesion is changing is if I compare it at two points in time. So patients come in and we get the photographs just once. That serves as a baseline, and then at future visits we can refer to these and confirm that given moles are stable and detect changing moles.

Then we educate patients and family members to use these photographs, and then we provide them to them to use at home. So patients are checking at home and they're also seeing us, and we've detected a lot of melanomas at an early stage. I think equally important, we've avoided a lot of unnecessary biopsies and surgeries because we can confirm spots aren't changing; we don't need to remove them.

Interviewer: Before mole mapping, what did you do?

Dr. Grossman: Well, when I first came here and we didn't have total body photography, I used to take photographs of individual areas of the skin where there were moles, again with the idea being that I'm trying to monitor individual moles. At the same time, we started taking high resolution photographs of individual moles, although about ten years ago we realized that wasn't the best approach.

Our studies have shown that most melanomas in fact don't evolve from moles. They develop in the normal skin. Only about maybe 30% of melanomas will arise from moles. So if you're only checking the moles, you're going to miss a lot of the new melanomas that are arising in the normal skin. So we really needed a total body approach, so we switched to full body photography and we've been doing that ever since.

Interviewer: If somebody took that tool away from you, would you be seriously hindered in what it is you are able to do for your patients, do you think?

Dr. Grossman: I would. Having a photograph gives me a huge advantage when I'm examining a patient. If I don't have a photograph, then really one is just guessing about which mole might be changing or be particularly suspicious.

Interviewer: You said it's a unique program to Huntsman Cancer Institute. Why aren't other places doing it? It seems pretty simple to take a picture of the body.

Dr. Grossman: It is simple, but it's expensive. We have to have someone available to take the pictures who's trained to do that, we have to have the equipment to take the pictures, we have to have the IT support to securely archive all the photographs from thousands of patients, and so it's not something that one could provide in an office space practice and have it be profitable. But through the support from the Cancer Institute, we're able to provide this to patients who come here.

Interviewer: How many lives do you think it has saved?

Dr. Grossman: Well it's hard to answer that question.

Interviewer: Sure.

Dr. Grossman: I do know that we've detected a lot of melanomas that patients were not aware of when they came in, and we were able to tell that from the photography. As I said earlier, also avoiding unnecessary procedures. Hundreds of thousands of lesions we avoided having to biopsy because I was able to confirm from the baseline photograph that there was no change.

Interviewer: Yeah. I think that's one of the big discussions in medicine right now: how do we avoid some of these unnecessary procedures that cost thousands of dollars.

Dr. Grossman: Right.

Interviewer: If somebody's looking for more information on mole mapping, to decide if it's something they're interested in, where can they get that information? We provide some basic information on the Huntsman Cancer Institute's website. If you go to that website and search "mole mapping," you'll find information we've provided.

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updated: May 21, 2019
originally published: September 9, 2014