Melanomas most often arise on normal skin, but they may also occasionally occur in conjunction with a benign nevus (beauty mark or birthmark). The identification of potentially malignant pigmented lesions is best remembered by using the first five letters of the alphabet as follows:
- A for asymmetry
- B for border irregularity
- C for color multiplicity
- D for diameter greater than ¼ inch
- E for evolution (change) in the size and/or shape
Melanomas may ulcerate and bleed and occasionally cause these lesions to itch or burn. In summary, melanomas are most often pigmented, asymmetric with respect to color and shape, and tend to enlarge or change over time. The presence or absence of hair follicles is of no significance.