Mole Mapping

The term mole mapping usually refers to a surveillance program for those at high risk of malignant melanoma. It may include a clinical skin examination and dermoscopy to identify and evaluate lesions of concern.

Mole mapping is intended to diagnose melanoma at the earliest possible stage, by identifying new moles or changes in preexisting moles. These features may be suspicious of melanoma if the lesion also has a disordered structure clinically or on dermoscopy.

Advantages and Disadvantages of Mole Mapping

Advantages Disadvantages

The previous record can be used to determine whether a lesion of concern is new or has changed.

There may be a melanoma in a hidden site that has not been imaged, such as the scalp or genitals.

If the doctor determines that a lesion has the criteria for removal, this can be done at the earliest possible stage, reducing the risk of melanoma and minimizing surgery.

Early melanoma may look like a normal mole or other benign skin lesion and might be missed (false negative).

If a lesion is new or has changed, but does not reach the threshold for removal, it can be reimaged and watched carefully.

A harmless lesion may be misdiagnosed as melanoma, resulting in unnecessary surgery and alarm (false positive).

Lesions that do have not structural disorder and have not changed are very unlikely to be melanoma and so may not need to be removed, reducing the potential cost, risks, and complications of surgery.

Melanoma may grow rapidly, particularly nodular melanoma; it may reach a dangerous size before the next planned visit for mole mapping.

Reassurance to patients and their health practitioner(s).

The procedure may be embarrassing.

What Mole Mapping Usually Involves

You will be asked to remove at least outer clothing. Let the staff know if you feel uncomfortable, especially if there are lesions of concern hidden by your underwear. Makeup, nail polish, and jewelry should be completely removed prior to the procedure. Long hair should be tied up.

You are likely to undergo the following steps:

Risk evaluation (ie, medical and family history, skin typing, sun exposure)

Patient education regarding sun protection, moles, and melanoma

Skin examination by a health professional (usually a doctor or specially trained nurse). This may involve:

  • Simply marking spots on a cartoon drawing of you to indicate the position of skin lesions of concern, particularly moles and freckles
  • Photographs or digital images of the whole body’s skin surface. These can be reviewed at a later date to see if there are any new skin lesions or whether preexisting skin lesions have grown or changed color or shape.

Evaluation of the images by an expert in skin cancer, usually a dermatologist

A report to you and/or your referring health practitioner including suspected diagnoses and recommendations for treatment of lesions of concern

Follow-up:

  • 3 to 6 months for lesions of concern that are not removed
  • 1 to 2 years or as recommended by your doctor for all routine follow-up

Copies of the images for you or doctor to aid in skin self-examination

Suitability for Mole Mapping

Mole mapping is particularly useful for individuals who have:

  • Many moles (more than 50 to 100)
  • Atypical or dysplastic nevi – moles that are large or of unusual color(s) or shapes
  • Moles on the back, which may be difficult to keep an eye on
  • Previous history of melanoma
  • Strong family history of melanoma
  • Moles and fair skin that has been severely sunburned
  • Concerns about individual moles or freckles, eg, because of their appearance or recent change

If you are considering undergoing mole mapping, discuss the procedure with your own doctor.

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