Specific types of melanomas include:

  • Superficial spreading melanoma.  Most common melanoma overall, accounting for 70% of all melanomas. Characterized by flat and asymmetrical shape, uneven coloring and outward growth across the skin. Occurs most often on the back in men vs. the backs of the legs in women.
  • Nodular melanoma. Fast-growing brown or black lump. Accounts for only 5% of melanomas, but is the most likely to result in more tumors. Typically appears on the trunk and limbs.
  • Lentigo maligna. Most common melanoma among the elderly. Characterized by flat, freckle-like spots on the face and other sun-exposed areas. Grows slowly, taking approximately five to 15 years for cancer to emerge.
  • Acral lentiginous. Most common melanoma for people of African and Asian descent. Appears as a dark patch on the palms, soles, fingers or toes, under fingernails or toenails or in mucus membranes.5

Risk factors

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Exposure to ultraviolet rays from sunlight or indoor tanning beds is the largest risk factor for melanoma, accounting for approximately 65% of melanoma cases, according to the Melanoma Research Foundation.6

People with fair skin, freckles or red or blond hair are at greatest risk for melanoma.7 Family history, past personal history, age and gender can also influence risk.

Recognizing melanoma symptoms

The first symptoms of emerging melanoma are a change in an existing mole or the development of a new pigmented or unusual-looking growth on the skin, according to the Mayo Clinic. Encourage patients to conduct regular self-exams in order to determine whether or not moles, freckles and other skin marks have remained the same without any changes.

Advise patients to stand in front of a full-length mirror and use a hand-held mirror to inspect their skin. Patients should check the fronts, backs and sides of their arms and legs, then go beyond the usual spots and look for potential problem areas in the groin, scalp, fingernails, soles of the feet and between the toes.8

The “ABCDE” method is a useful acronym for determining which moles may signify melanoma:

  • Asymmetry – one half of the mole or skin growth does not match the other
  • Border irregularity – ragged, notched or blurred edges
  • Color – non-uniform pigmentation or changes in color distribution
  • Diameter – mole or skin growth is larger than 6 mm (0.25 in)
  • Evolution – change in the size or shape or emergence of symptoms such as itching, tenderness and bleeding.

Moles that are generally benign and safe from evolving into a form of melanoma include those with:

  • Uniform color (tan, brown or black)
  • A distinct border separating the mole from the surrounding skin
  • An oval or round shape
  • A diameter smaller than 6 mm

If a mole or skin growth is suspected to be melanoma, referral to a dermatologist for a biopsy remains the only reliable method to make an accurate diagnosis.

Ruling out benign conditions, such melanocytic nevi and myxoid fibrohistiocytic lesions are also important. Many clinicians use a combination of imaging approaches and devices, including dermoscopy, dermatoscopy or epiluminescence microscopy to help differentiate between these skin disorders and melanoma.9

“Promoting these practices and increasing men’s skin cancer awareness and examination practices should be labeled as priorities,” Sondak and colleagues wrote. “If even a portion of the observed 30% gender-based differences in outcome can be eliminated by focused early detection and prevention strategies in men, this could save many lives in the United States and around the world each year.”

Dom Nicastro is a freelance medical writer based in Danvers, Mass.


  1. WebMD. Melanoma/skin health center.
  2. Skin Cancer Foundation. Skin cancer facts.
  3. Sondak VK, Swetter SM, Berwick MA. “Gender disparities in patients with melanoma: breaking the glass ceiling.” J Clin Oncol. 2012; 30 (18): 2177-2178.
  4. Cleveland Clinic. The facts about melanoma.
  5. Melanoma Research Foundation. Causes of melanoma.
  6. Melanoma in-depth report. New York Times.
  7. American Cancer Society. Melanoma skin cancer overview.
  8. Mayo Clinic. Tests and diagnosis.
  9. New York Times. Diagnosis. Published July 28, 2011.