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North Atlanta Dermatology
Gabrielle M. Sabini, M.D. Gabrielle M. Sabini, M.D.

The ABCDE’s of Melanoma

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. Most melanomas can be treated successfully if they are detected at an early stage. If melanoma is not detected at an early stage, it can spread to other parts of the body and is potentially a lethal form of cancer.

Since most pigment cells are in the skin, most melanomas start on the skin. They can occur in the eye and rarely in the membranes of the nasal passages, oral and pharyngeal mucosa, vaginal and anal mucosa.

Melanomas can arise from an existing mole or on normal skin.  Anyone can get Melanoma.

For many years, the early warning signs of melanoma have been identified by the acronym "ABCDE" (A stands for Asymmetry, B stands for Border, C for Color, D for Diameter and E for Evolving or changing was recently added.). While the ABCDE rule helps detect many melanomas, there are a group of melanomas that do not manifest the ABCDE features. Recently, several melanoma specialists developed a new method of sight detection for skin lesions which could be melanoma.

This new method of sight detection for skin lesions is based on the concept that these melanomas look different -- ie, "the ugly duckling" -- compared to surrounding moles. Thus, during skin self examination, patients and physicians should be looking for lesions that manifest the ABCDE's AND for lesions that look different compared to surrounding moles.

The doctors suggest thinking of "the ugly duckling" mole, aka "the outlier", as the lesion that, at a given moment in time, looks or feels different than the patient’s other moles or that over time, changes differently than the patient’s other moles. The "ugly duckling" methodology may be especially useful in the detection of nodular melanoma, a dangerous type of melanoma, which notoriously lacks the classic ABCDE signs.

We at North Atlanta Dermatology strongly suggest everyone have a yearly full body exam with a board certified dermatologist for the detection and treatment of all types of skin cancers.

ABCDEs of Melanoma Detection

Look for Danger Signs in Pigmented Lesions of the Skin

Consult your dermatologist immediately if any of your moles or pigmented spots exhibit:


One half is unlike the other half.


An irregular, scalloped, or poorly defined border.


Is varied from one area to another; has shades of tan, brown, or black; is sometimes white, red, or blue.


Melanomas usually are greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.


A mole or skin lesion that looks different from the rest or is changing in size, shape, or color


North Atlanta Dermatology

Duluth Office:
3850 Pleasant Hill Road
Duluth, Georgia 30096

Johns Creek Office:
6610 McGinnis Ferry Road, Suite 200
Johns Creek, Georgia 30097

Hamilton Mill Office:
3331 Hamilton Mill, Suite 1106
Buford, GA 30519

Main Phone Number: (770) 814-8222

More on this topic: Melanoma at a Glance »