What is the Ugly Duckling Sign?

 When a dermatologist examines your skin to look for  melanoma, a deadly form of skin cancer, they look at each mole for certain characteristics. Generally, they follow the ABCDE"S of melanoma detection.

A = Asymmetry (one half of your mole does not look like the other half)
B = Border (irregular, scalloped, or poorly defined border)
C = Color (color variation within a mole; shades of tan and brown, black; sometimes white, red, or blue)
D = Diameter (melanomas are most often greater than 6 mm (the size of a pencil eraser) but they can be present as a small dot.
E = Evolving (changing in size, shape, and color)
S = Symptoms (a mole becomes painful or begins to bleed or itch)

What if all or most of your moles have an irregular shape or have a color variation? What if you were born with large moles? I start looking for the "Ugly Duckling" sign. This represents a mole that is different in appearance than all of your other moles. Moles (nevi) in the same individual tend to resemble one another and that melanoma or an atypical mole (nevus) is often the "ugly duckling", different from the other moles. This is not used as the sole criteria but is helpful to pick out which moles may need biopsy. In my opinion, another very important criteria are ANY changes in a mole. Make sure that you do periodic self-exams and see your dermatologist immediately if you notice anything changing, growing, or bleeding. Also, if you spot an "ugly duckling" tell your dermatologist!