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Senior Citizen Health & Medicine
Cancerous Melanomas Are
‘Ugly Ducklings’ of Skin Moles, Study Finds
This cancer that is an
increasing problem for older men has always been noted for its unusual
appearance
 Jan.
21, 2008 – It is not exactly news but it is a good reminder. A study in
the January issue of the Archives of Dermatology, one of the JAMA/Archives
journals, says melanomas – the skin cancer that likes to hit older men –
are the “ugly ducklings” of skin moles.
Rates of malignant
melanoma continue to increase, and early identification allows surgeons
to treat the disease by removing the tumor.
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The disease is more common
in individuals with many moles or other skin marks, especially if the
marks are atypical in color, shape or size.
“The challenge for
clinicians who diagnose and treat pigmented skin lesions is to
distinguish between malignant melanoma and benign simulants,” the
authors write.
Alon Scope, M.D., of the
Memorial Sloan-Kettering Cancer Center, New York, and colleagues
obtained images of the backs of 12 patients from a database of
standardized patient images.
All of the patients had at
least eight atypical moles, and five patients had one lesion that had
been confirmed as a melanoma. Thirty-four study participants—including
eight pigmented lesion experts, 13 general dermatologists, five
dermatology nurses and eight non-clinical medical staff—were asked to
evaluate the images and identify lesions that looked different from all
other atypical moles.
All five melanomas and
only three of 140 benign lesions (2.1 percent) were generally apparent
as different, meaning that two-thirds of the participants identified
them as “ugly ducklings.”
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About Melanoma
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Melanoma is the most
serious type of
skin cancer. Often the first sign of melanoma is a change in the
size, shape, color or feel of a mole. Most melanomas have a black or
black-blue area. Melanoma may also appear as a new mole. It may be
black, abnormal or "ugly looking."
Thinking of "ABCD" can
help you remember what to watch for:
Asymmetry - the shape of
one half does not match the other
Border - the edges are
ragged, blurred or irregular
Color - the color is
uneven and may include shades of black, brown and tan
Diameter - there is a
change in size, usually an increase
Melanoma can be cured if
it is diagnosed and treated early. If melanoma is not removed in its
early stages, cancer cells may grow downward from the skin surface and
invade healthy tissue. If it spreads to other parts of the body it can
be difficult to control.
>>
More information at MedlinePlus
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“The malignant melanomas
were apparent as being different to at least 85 percent of participants,
whereas the agreement rate on the benign lesions perceived as being
different was 76 percent at most,” the authors write.
“Four lesions were
generally apparent as completely different, all four being malignant
melanomas.”
For all participants, the
test had a sensitivity of 90 percent, meaning 90 percent of the
melanomas were identified as different.
Sensitivity was 100 percent for
the pigmented lesion experts, 89 percent for general dermatologists, 88
percent for nurses and 85 percent for non-clinicians.
“Although the sensitivity
and specificity and diagnostic accuracy of the ugly duckling sign
depended on clinical expertise, the values for these parameters were
good in all subgroups of participants,” the authors write.
“These
preliminary findings suggest that the ugly duckling sign may prove to be
a useful screening strategy for primary health care providers and even
for skin self-examination.”
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