People with dysplastic nevus syndrome have a large number of moles, sometimes a few 100s, and some of the moles fail one or more ABCD criteria (Asymmetry, Border irregularity, Color variation and Dimension). These individuals are at a higher risk of developing malignant melanoma.
Because malignant melanoma can spread (metastasize) rapidly, individuals with dysplastic nevus syndrome should perform self-examination of the skin often and report to their physician any new or changing moles.
However, monitoring changes in the size, shape and color of 100s of moles can be a challenging and time-consuming endeavour. Below I discuss 3 methods of mole monitoring for dysplastic nevus syndrome patients.
- Body Diagram
Using a pen, you can draw the shape of your body, or parts of your body, in a paper notebook. Alternatively, you could print a body diagram from the Internet. Using pens of different colors, you can mark small dots on the diagram, potentially mapping hundreds of mole on body by devising your own “color code.”
- Yellow dot: 1-2 mm mole.
- Black dot: 2-3 mm mole.
- Green dot: 3-4 mm mole.
- Blue dot: 4-5 mm mole.
- Red dot: 5-6 mm mole. Etc.
For moles that have an irregular shape or color, you can draw the actual shape and color of the mole on the diagram so that you have an accurate recording of the mole for future comparisons. If you notice a mole changing size, shape or color, you can make a note, beside the mole on the diagram, of the date you have noticed the change.
- Digital Camera
Using a digital camera to take pictures of your skin can be very useful for comparing moles over time, in case you believe that a mole used to look different in the past. You can take pictures of large areas of the skin or you could locate the camera a few short centimeters away from the skin to take pictures of specific moles at a higher resolution.
For the images to be a good representation of what your moles look like, you would need to experiment with lighting and with using the flash of your camera. It is also very important that the lens of the camera be parallel to the area of the skin that you are taking a picture of. Since the human body is 3-dimensional and has curvatures, if you have hundreds of moles across your body you may need to take many images to correctly cover all your moles.
For people with dysplastic nevus syndrome, because of the large number of moles, it may be more practical to use the “manual” body diagram (see above) for an initial scanning of their moles (once a month, or once every three months), and refer to digital images of the moles only if they suspect that a mole has changed.
Other “issues” with digital images are that they do not automatically record the size of moles; if you would like to record the size of a mole you need to measure it with a ruler and make a note to yourself. Or alternatively, you could hold a ruler close to your skin when taking the picture so that the picture includes an image of the ruler (however, because of the curvatures of the body, this is not very practical, unless you wish to measure only a few moles). When taking follow-up images of the same moles, you should use the same camera settings that you have used in the past and the same distance between the camera and the skin so that the moles don’t look visually different in the pictures just because of the camera.
MoleSense is a device with software that makes monitoring moles easier and more accurate than when using a digital camera alone, especially if you have many moles. The product includes a camera mount/rail for maintaining a constant distance between your digital camera and your skin, and software that automatically measures and analyzes the ABCD features of skin moles in digital images. You can download a free version of the MoleSense software at the manufacturer’s Web site (Opticom Data Research).