listen to your wife!
This very odd looking naevus was noticed on a 30 year old man’s back by his wife, who was sure it wasn’t there, or at least not like that, a year ago. A loved one’s concern about a changing mole should always be heeded. In the ABCDEF mnemonic, E is for Evolution, meaning change over time. I also say it’s for Erythema (redness) as melanoma stimulates the immune system and causes redness. Red, black and brown is an evil colour combination in a mole.
On plain view, the lesion is strikingly asymmetrical. The patient had about 50 moles on his trunk, average size 3-5 mm. All but this one were round or oval with even medium brown with no atypia This mole stood out dramatically from all the other moles thus was an ‘ugly duckling’. It fails A (Asymmetry) C (mixed Colour) D (Diameter over 6mm) and F for Funny (funny peculiar, not funny hilarious.)
Dermoscopy shows irregularly sized and asymmetrically distributed globules over a medium brown cobblestone appearance to this part of the mole, plus an amorphous blue/black blotch with a suggestion of a blue/white veil. There was no option but to excise urgently for histology. It was a thin, and so good outlook melanoma.
Men, if you are fortunate enough to have a wife, LISTEN TO HER. Especially when she says ‘I don’t like the look of that mole on your back, please get it checked.’