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Key Features

  • Benign mole

    • Small (< 6 mm) lesion with a well-defined border

    • Single shade of pigment from beige or pink to dark brown

  • Stages of nevi

    • First decade: junctional nevi are nevus cells are at the junction of the epidermis and dermis; appear as flat, small, brown lesions

    • Over next 2 decades: Compound nevi are moles that have enlarged and become raised, reflecting appearance of a dermal component

    • As white patients enter their eighth decade: most moles lose their junctional component and dark pigmentation

Clinical Findings

  • Normal moles should be well-demarcated, symmetric, and uniform in contour and color

  • May darken and grow during pregnancy

Diagnosis

  • Physical examination must take precedence over the history

  • Benign nevi must be differentiated from malignant melanomas

  • Signs of melanoma can be remembered by the mnemonic: ABCDE with A = Asymmetry; B = Border irregularity; C = Color variegation; D = Diameter greater than 6 mm; E = Evolution

Treatment

  • None required; benign moles have a normal natural history

  • Regular mole screening is not an evidence-based recommendation for all adults although rates of such screening continue to rise

  • Moles that are atypical in any fashion that suggests melanoma should be excised and submitted for pathologic examination

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