Anyone who is fair-skinned, sunburns easily, or has a lot of moles on their skin should see a dermatologist or a good primary care doctor for skin checks once a year. These can be part of a routine physical exam. The doctor should measure and do sketches of the moles’ location and appearance on your skin, or should take good photographs. A change in a mole is one of the key indicators of potential for malignant melanoma, a skin cancer which is deadly once it gets into the bloodstream but is 100% curable when still confined to the skin. Patients and their families often don’t notice subtle changes in a mole — getting bigger, changing color, etc. — that health care providers can pick up.
In the legal case of Semsker v. Lockshin, a benign mole on the patient’s lower back turned into a deadly melanoma over an eight-year period, during which time the mole’s presence and change in size was documented by the dermatologist. The lawsuit alleged the dermatologist should have removed the mole two years before it finally was removed, when it had already invaded the patient’s lymph nodes. Mr. Semsker died 14 months after the diagnosis – from spread of the melanoma to his brain. Read more about this case on the Track Record page of our website.
In their defense of the malpractice lawsuit, the dermatology practice of Norman Lockshin, M.D., P.A., contended that they would have told the patient to get skin checks even more often than he was (every few years from either his primary doctor or his dermatologist), although this recommendation was not documented in their records.
Regardless, every patient needs to know about the dangers of melanoma and the need for regular skin exams.
Exams should focus on the ABCDE’s of skin cancer:
- A for Asymmetry of the mole;
- B for irregular Borders;
- C for variegated Color or unusual color in the mole;
- D for diameter greater than 6 millimeters, and
- E for Evolution or changes in the mole’s size, shape or color.
Skin moles are one of those things where it’s easy to put off going to the doctor. They don’t hurt, they’re not big, and we have busy lives. But putting off a competent skin exam and a biopsy if there’s any suspicion can be a deadly mistake.
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