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For further information, see CMDT Part 6-03: Melanocytic Nevi (Normal Moles)

KEY FEATURES

  • Benign mole is generally

    • Small (< 6 mm) macule or papule with a well-defined border

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

  • Typical natural history of moles

    • Early in life: moles appear as flat, small, brown lesions; termed “junctional nevi” because the nevus cells are at the junction of the epidermis and dermis

    • Over time: moles enlarge and often become raised, reflecting the appearance of a dermal component, giving rise to “compound nevi”

    • 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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