melanomaMelanoma is the most serious form of skin cancer. However, if it is recognized and treated early, it is nearly 100 percent curable. If not treated promptly, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. Although it is not the most common of the skin cancers, it causes the most deaths.

Melanoma is a malignant tumor that originates in melanocytes, the cells which produce the pigment melanin that colors our skin, hair, and eyes. The majority of melanomas are black or brown. However, some melanomas are skin-colored, pink, red, purple, blue or white.

Risk factors for melanoma include: sunbathing, tanning bed use, fair skin, family history of melanoma, multiple dysplastic nevi, personal history of other types of skin cancer, and weakened immune system.

ABCD’s of Melanoma

  • Asymmetry — if you draw a line through a normal mole, the two halves match; in contrast, most melanomas are asymmetric.
  • Border irregularity — the borders of a melanoma tend to be uneven and appear scalloped
  • Color — having a variety of colors within the same mole is concerning
  • Diameter — melanomas are often greater than the size of a pencil eraser or 6 mm when first detected.
  • Evolution — any change such as itching, change in color, size, shape may suggest something concerning
NOTE: Often patients are confused by the above rules — a better rule of thumb is to be suspicious of anything different than your other moles. For example, if all of your moles are light brown, a lone dark black mole would be concerning.


For the vast majority of melanomas, simple excision is adequate. The margins of the excision (amount of normal skin we take in addition to the lesion) are determined by the depth of the lesion on the original biopsy. If the melanoma is greater than 1 mm depth, we often recommend that the patient consider a sentinal lymph node biopsy to sample the node most likely to drain the region of the melanoma at the time of the excision. Your provider will discuss the best plan of care for the depth of your melanoma.