I’ve had to leave town recently a loved one was having a major surgery for a malignant melanoma. I saw the suspicious skin lesion over the Christmas holidays and urged the relative to get it removed. Thank God, a biopsy was performed and removed today before it grew too much. (This out-of-town trip and my recent move is one of the reasons I’m a little tardy getting through my Things-To-Do list recently, so if I told you I was going to do something for you, whether it’s a consult letter or a lab order or a school note, be patient with me. I’ll get to it. One patient recently quit my practice because I was a week and a half late with sending them a lab order. That’s not that long of a wait for a routine lab order! Please be patient and text me if I told you I would do something for you and haven’t yet.)

One of the perks of my family practice is I do most my patients’ dermatology. I took off a large melanoma off a patient a few months ago, and as soon as I saw the biopsy report, I consulted a dermatologist for a wide excision of the area to reduce the chances of recurrence. At no extra charge, I can save you some significant expense and some treatment delay and take off suspicious lesions in the comfort of your home. Make a two hour appointment if you have something you’d like me to look at and possibly remove.

While basal cell cancers or squamous cell cancers are more common and relatively easy to remove, malignant melanomas are more likely to cause death and disability because they can metastasize relatively quickly. So it is important to be aware of what to look for, especially if you’re sensitive to the sun or you have a family history of melanoma.

Changes in the size, shape, color, or feel of a skin lesion are often the first warning signs of melanoma. These kinds of changes can occur in an existing mole or skin lesion, or melanoma may appear as a new or unusual-looking mole or spot. The “ABCDE” rule is helpful in remembering the warning signs of melanoma:

• Asymmetry. If the shape of one-half of the skin lesion does not match the other half, this increases suspicion for melanoma.

• Border. If the edges of the skin lesion are ragged, notched, uneven, or blurred, that increases suspicion.

• Color. Shades of black, brown, and tan may be present. Areas of white, gray, pink, red, or blue may also be seen. The darker it is, the more suspicious it is. And the less uniform and more diverse in color it is, the more suspicious it is.

• Diameter. If the diameter is larger than 6 millimeters or it has grown in size, the greater the suspicion for melanoma.

• Evolving. If the mole or lesion has been changing in size, shape, color, or appearance, or it is growing in an area of previously normal skin, that increases suspicion. Also, when melanoma develops in an existing mole or lesion, its texture may change and become hard or lumpy. The mole or lesion may feel different and may itch, ooze, or bleed, but a melanoma skin lesion usually does not cause pain.

I have removed suspicious lesions that met almost none of these criteria, and surprisingly turned out to be a melanoma. So when it doubt, make an appointment and I will take a look at your skin and biopsy or excise any suspicious skin lesion.