Cure requires early diagnosis and appropriate surgery. Family practitioners, internists and patients themselves must recognize the early-warning signs that ordinarily occur in sequence: darkening of an existing mole, an increase in its size, irregularity of margins and elevation of the lesion . The American Cancer Society's often quoted sign of bleeding is one of the later signs of the disease.
Further changes in the color of the mole, such as depigmentation of a portion of it or a reddish or bluish tinge, may also occur. Bleeding usually occurs after some minor injury sometime after these changes become apparent. Itching is common, as is scaling or crusting of the lesion. Occasionally, an entirely new pigmented spot appears.
It should be emphasized that most pigmented spots are not melanomas. Chronic inflammatory conditions, benign fibrous tumors (fibromas) and basal cell carcinomas—one of the most common low-malignancy skin tumors—are sometimes pigmented. Benign tumors can also bleed after being irritated by underwear or after shaving. It is nevertheless better to bring any suspicious changes to the attention of a doctor. It is far better to risk being thought a hypochondriac than to run the risk of letting a melanoma get out of hand.
