Benign nevi may develop atypia or become melanoma. This should be suspected if a lesion has atypical features including asymmetry, border irregularity, color variability, diameter greater than 6 mm, and evolving (called the ABCDE approach [asymmetry, border irregularity, color irregularity, diameter >6 mm, evolution]). Any lesion that becomes symptomatic (e.g., itchy, painful, irritated, or bleeding), or develops a loss or increase in pigmentation, should be evaluated and biopsied if needed. Dermoscopy can be used to increase one's accuracy in distinguishing between benign and malignant lesions (see Appendix C, Dermoscopy).