Melanoma Diagnosis

Melanomas vary greatly in the way they look. The first sign of a melanoma is usually a change in an existing freckle or mole or the appearance of a new spot.

The earlier the diagnosis, the higher the chance of successful treatment.

The most common system for detecting a melanoma is the ABCDE rule. However not all melanomas obey the rules and expert assessment is important.

ABCDE System

A-Asymmetry (one half unlike the other)

B-Border (irregular, ragged or notchy edges)

C-Colour (Many shades of brown and black, sometimes white, red or blue)

D-Different, or “ugly duckling sign”

E-Evolving (elevation, change)

Most skin cancer experts now use both clinical assessment of skin lesions and a dermatoscope. A full skin check constitutes: A useful tool is total body photography which provides a baseline for future assessment. Some Doctors also use a Dermatoscope (the use of a special magnifying instrument called a dermatoscope to examine skin lesions) to look at skin lesions.

Dermatoscope Image of Melanoma

It is normal for new moles to appear and change during childhood and pregnancy. However, in adults a new mole could be a melanoma. Always ask your doctor to look at your skin if you are concerned.

Melanoma can occur anywhere on the body, but usually develops in areas that are exposed to the sun.

What constitutes a professional skin check?

If you are at increased risk of melanoma, including having had melanoma before, you and your partner are advised to learn to recognise suspicious lesions. You should also discuss professional skin monitoring with your doctor. The Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand suggest being regularly checked by a clinician with a full body examination, supported by total body photography and dermoscopy as required.

For more information on what to expect during a full skin check, download a PDF from Melanoma New Zealand.

Skin checks can be carried out by:

  • GPs with a special interest in skin cancer and are trained in dermoscopy.
  • Dermatologists (skin specialists). Your doctor can refer you or you can make an appointment directly.
  • Other skin specialists such as Surgeons.

Various mole or skin check services are available. Many use technologies such as whole body photography, digital dermoscopy and computer-based monitoring to track skin changes over time.

If your doctor is concerned about a lesion he will perform an excision biopsy using local anaesthetic (numbing injection). There are various ways of doing this but the important thing is that a Pathologist examines the specimen so that a diagnosis can be made.

Excision biopsy