Atypical moles are benign pigmented lesions. WebAn excisional biopsy should be considered in the initial evaluation of atypical mole for histologic confirmation of dysplastic nevi versus melanoma. Dinulos JGH. The decision to re-excise a severely atypical nevus is based on the concern that the residual lesion could become (or is) melanoma. Pediatric Clinics of North America. WebMost Spitz nevi appear on the skin during the first 20 years of life. Congenital nevi are sometimes removed by surgery so that they dont have a chance to become cancer. Some people have only a couple of dysplastic nevi, but other people have more than 10. However, people with dark skin tend to be diagnosed with more advancedmelanoma than people with fair skin (5). Only rarely does a common mole turn into melanoma, the most serious type of skin cancer. Moles are usually harmless. Ocular melanoma 5-year survival rates: Some evidence suggests that melanomas that start in these areas are different from those that start on the face, neck, and arms, where the sun exposure is more constant. https://www.aad.org/media/stats-sunscreen#.UbdQaJzm9lP. This means 92 of every 100 people diagnosed with melanoma will be alive in 5 years. The mole may become hard or lumpy and the surface may ooze or bleed. Nevi and malignant melanoma. 11th ed. Most Americans (about 332 million people) have common moles. This common mole is 2millimetersin diameter (the width of the tip of a new crayon). There is a problem with 2014; doi:10.1097/CEJ.0000000000000053. Another weakness of the ABCDE mnemonic is that many common benign lesions, such as seborrheic keratoses, lentigines, and warts, will screen positive for possible melanoma. In fact, only about 25 percent of melanoma cases start from dysplastic nevimost melanoma appear on their own, according to a 2020 review in StatPearls Publishing. This sequence is the normal life pattern of a nevus. Those diagnosed with dysplastic nevi have an excellent prognosis. The lifetime risk of melanoma developing in congenital melanocytic nevi is estimated to be between 0 and 5%, Physicians take all these findings into account to pinpoint the severity of the disease and diagnose the melanoma stage. It is potentially dangerous because it can invade nearby tissues and spread to other parts of the body, such as the lung, liver, bone, or brain. With those caveats in mind, a prevalence of 2% to 8% in fair-skinned persons is a valid estimate.3,4 In persons with skin of color, the prevalence of atypical moles is significantly lower (5% to 21% of the fair-skinned rate). However, if you have a history of dysplastic nevi you have a greater risk of developing melanoma in the future. Our team is made up of doctors andoncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. If at least one close relative has had melanoma, this condition is referred to as familial atypical multiple mole and melanoma syndrome, or FAMMM. Regular skin checks, both self-checks and those done by health-care professionals, are key to preventing complications from melanoma. Advanced melanomas are harder to control and typically have a worse prognosis than melanomas diagnosed at an earlier stage. Flesh moles don't carry a risk of melanoma, but they can be treated if you consider them a cosmetic concern. Below are some of the resources we provide. For instance, while treatment may be similar for stage 2A and stage 2C melanoma, recurrence rates are higher for the latter, Ariyan says. To give a sense of relative tumor sizes in stage 1 melanoma, the NCI website notes that a sharp pencil point is about 1 millimeter thick. They may contain hairs or become raised or wrinkled. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Some risk factors, like smoking and excess sun exposure, can be changed. Accessed at https://www.uptodate.com/contents/risk-factors-for-the-development-of-melanoma on June 10, 2019. However, there still is contention regarding the significance of dysplastic nevi. This inherited condition is also called atypical mole syndrome. The sample will be sent to a lab and a pathologist will look at the tissue under a microscope to check for melanoma. They Rarely, they become cancerous. Most people have 10 to 40 moles that appear during When melanoma develops in women, it is often found on the back or the lower legs. WebWould the mole become cancerous if left? However, people of any racial or ethnic group can develop melanoma and should have skin changes evaluated. Weve invested more than $5 billion in cancer research since 1946, all to find more and better treatments, uncover factors that may cause cancer, and improve cancer patients quality of life. Mayo Clinic is a not-for-profit organization. WebThe importance of the dysplastic nevus syndrome is that it identifies an at-risk population group for the subsequent development of melanoma. All Rights Reserved. When it comes to the detection, skin cancers actually give patients an advantage. They produce melanin, the natural pigment that gives skin its color. Most melanocytes are in the skin, and melanoma can occur on any skin surface. Spitz nevus This type of mole is often pink, raised, and dome-shaped. This might also have something to do with the fact that these areas aren't constantly exposed to UV light. WebDysplastic nevi have become an increasing focus clinically, with evidence that they are associated with a higher risk of developing melanoma. How can people protect their skin from the sun? Most experts dont recommend that people with a family history of melanoma have genetic testing to look for mutations that might increase risk, as its not yet clear how helpful this is. Sometimes, people or their doctors take photographs of dysplastic nevi so changes over time are easier to see (2). They often appear as small, dark brown spots and are caused by clusters of pigment-forming cells (melanocytes). Another important difference is that a common mole or dysplastic nevus will not return after it is removed by a full excisional biopsy from the skin, but melanoma sometimes grows back. Survival rates. How Do I Protect Myself from Ultraviolet (UV) Rays? WebA diagnosis of dysplastic nevus requires that a person have at least 50 or more of the atypical moles on their body called dysplastic nevi. But moles come in different colors, shapes and sizes: Moles can develop anywhere on your body, including your scalp, armpits, under your nails, and between your fingers and toes. Has any changes to the texture, especially if it becomes scaly or dry. Some people have higher-than-average risk of their moles becoming cancerous and developing into melanoma. Another name for a mole is a nevus. This page was updated on October 19, 2022. However, dysplastic nevi are a risk factor for developing melanoma, and the more dysplastic nevi a person has, the greater their risk of developing melanoma (1, 3). Its also important to follow recommended screening guidelines, which can help detect certain cancers early. Normally, people do not need to have a dysplastic nevus or a common mole removed. WebDysplastic nevi usually become clinically apparent at puberty or adolescence, but true dysplastic nevi have been described in prepubertal children. At least one study indicates a cumulative lifetime risk of nearly 100% in individuals who have dysplastic nevi and are members of melanoma kindreds. In fact, between 1995 and 2014, head and neck melanoma cases increased by more than 50% among people from infants to adults under 40, according to a study published online October 3, 2019, in the journal JAMA OtolaryngologyHead & Neck Surgery. information highlighted below and resubmit the form. 28, 2023, Lisa Esposito and Elaine K. HowleyFeb. This content does not have an English version. All rights reserved. Atypical moles are characterized by size of 6 mm or more at the greatest dimension, color variegation, border irregularity, and pebbled texture. It is round or oval, has a smooth surface with a distinct edge, and is often dome-shaped. When an abnormal skin area causes concern, you should pay your primary care provider or dermatologist a visit. For example, in 20172018, the lifetime risk of being diagnosed with melanoma was 2.9% (1 in 34) for White people but 0.1% (1 in 1,000) for Black people and 0.5% (1 in 200) for Hispanic people. 2023 American Cancer Society, Inc. All rights reserved. In addition, many doctors recommend that people with dysplastic nevi check their skin once a month (2, 4). Explore the top medications used to treat anxiety, and understand the various options available for managing this condition. Melanoma is classified into five basic stages, from stage zero and earlier stages 1 or stage 2 to more advanced stage 3 or stage 4 disease. American Academy of Dermatology. Many of these develop by age 50. These statistics can be confusing and may lead you to have more questions. Gibson LE (expert opinion). At the American Cancer Society, we have a vision to end cancer as we know it, for everyone. Other risk factors include having many moles, having an inherited skin condition called dysplastic nevus syndrome and having moles at birth. And some people who get it may have few or no known risk factors. Some moles will not change at all and some will slowly disappear over time. Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. That is why doctors usually remove only moles that have changed or new colored or otherwise suspicious areas on the skin. The lifetime risk in patients with FAMMM syndrome approaches 100%. FAMMM syndrome, the most well-known genetic mechanism, is characterized by the presence of more than 50 combined common and atypical moles plus a first- or second-degree relative with melanoma. People with dark skin are much less likely than people with fair skin to develop melanoma. These patients usually have an increased number of typical melanocytic naevi appearing in childhood, with AMN first appearing in adolescence. (If theres only one mole, its called a nevus.) However, every mole is unique, and some look more abnormal than others. Elsevier; 2021. https://www.clinicalkey.com. Our syndication services page shows you how. The best way to treat a dysplastic nevus depends on its category. Goodson AG, Grossman D. Strategies for early melanoma detection: Approaches to the patient with nevi. Melanoma that runs in families may occur at a younger age. European Journal of Cancer Prevention. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. More photos are on the What Does Melanoma Look Like? JAMA Dermatology 2022; 158(4):414425. Also searched were Essential Evidence Plus, the National Guideline Clearinghouse, UpToDate, and the U.S. Preventive Services Task Force. This contribution provides an overview of the history, epidemiology, genetic They are more common in fair-skinned individuals and in those with high sun exposure. http://www.bmj.com/content/348/bmj.g3739.full.print? While UV rays make up only a very small portion of the suns rays, they are the main cause of the damaging effects of the sun on the skin. There is some evidence to suggest an increased melanoma yield based on photographic change in lesions that were not strongly suspected to be melanoma by appearance alone.13,14 Magnified evaluation of atypical moles with dermoscopy can be helpful in identifying lesions that merit biopsy, although outcomes are dependent on the skill of the operator.13,25,27 A recent review of dermoscopy published in American Family Physician is available at https://www.aafp.org/afp/2013/1001/p441.html. Your dermatologist will go over your treatment options in detail. What is my prognosis if I have a dysplastic nevus? Those diagnosed with dysplastic nevi have an excellent prognosis. However, if you have a history of dysplastic nevi you have a greater risk of developing melanoma in the future. If a close relative has had melanoma, this syndrome is referred to as familial atypical multiple mole melanoma syndrome (FAMMM), and it signals a significant lifetime risk of developing melanoma. The lifetime risk in patients with FAMMM syndrome approaches 100%.8,9 Followed over five years, one-half of atypical moles remained unchanged, 15% developed increasing atypia, and 35% regressed or disappeared.8,10,11 Studies have reported a 0.5% to 46% rate of progression to melanoma, with this wide range attributable to differing diagnostic criteria.8,11 Still, the key message to convey to patients is that although most atypical moles do not become melanoma, patients with a high number of atypical moles have an increased lifetime risk of melanoma.3,12 Thus, it is important to be equally vigilant for changes in existing moles and new lesions. WebDermal nevi are clinically manifested as pale soft wrinkled polyps on the skin. The 5-year survival rates for melanoma, according to the American Cancer Society are: Local (cancer has not spread beyond where it started): 99 percent. In addition, youll learn about next-phase treatments such as immunotherapy or targeted chemotherapy drugs for later-stage disease. Although the differences within stages might seem subtle, they matter. Dysplastic nevi often run in families. When melanoma develops in men, it is often found on the head, neck, or back. For example, people who get organ transplants are usually given medicines that weaken their immune system to help prevent them from rejecting the new organ. Copyright 2015 by the American Academy of Family Physicians. Melanoma is a type of skin cancer that begins in melanocytes. The skin on the surface may break down and look scraped. We can also help you find other free or low-cost resources available. If the pathology exam reveals that the sentinel lymph nodes near the primary tumor contain cancerous cells, melanoma is classified as at least stage 3. And about 7,230 people will die of melanoma in the same year, according to SEER estimates. They may be referred to as atypical moles or Clarks nevias well. The agreement between the clinical diagnosis of an atypical mole and the pathologist's interpretation of dysplasia has been reported as low as 60%.12. 28, 2023, Lisa Esposito and Michael O. SchroederFeb. Most cases start in the skin and are called cutaneous melanoma. 7th ed. Also, melanoma is cancer, so it can spread to other parts of the body. 10 Seemingly Innocent Symptoms You Shouldn't Ignore. During surgery to remove the original tumor, your doctor may also biopsy nearby lymph nodes to do additional testing for cancerous cells. (Some doctors use the term "atypical mole" to refer to a dysplastic nevus.) Moles may change or fade away over time. People with very large congenital Only rarely does a dysplastic nevus turn into melanoma (1, 3). Current knowledge of immunosuppression as a risk factor for skin cancer development. These moles may be sporadic or inherited. A small percentage of dysplastic nevi may develop into melanomas. WebSmooth. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Dysplastic nevi stand out from normal moles in a few ways. Common moles tend to cover most adults with about 10 to 40 small, rounded, brown or black spots or growths in areas that get sun exposure. In older people, common moles tend to fade away. Begins as a flat, smooth spot on the skin. Melanoma can appear on the skin in several ways. Most adults have between 10 and 40 common moles. However, if the mole looks suspiciously like melanoma, as some dysplastic nevi do, your doctor may perform a biopsyto check a tissue sample for melanoma. This is likely not necessary because clinical recurrence of lesions with mild to moderate atypia extending to the margin is extremely rare on prolonged follow-up. Melanocytes are generally distributed throughout the skin. Both common and atypical moles decrease in number with age, starting in the 20s, although atypical moles continue to appear throughout life. Although physicians may readily recognize these benign lesions, patients often cannot make the distinction. Accessed Oct. 8, 2021. Dysplastic nevi are diagnosed after a biopsy is done on a suspicious mole. Blood tests. depending on the size of the nevus. 28, 2023, Ruben Castaneda and Angela HauptFeb. Mayo Clinic; 2021. Overall, saucerization and punch biopsies lead to accurate diagnosis and thickness determination 88% of the time compared with later definitive excision, and are accepted practice.29,30, When melanoma is ruled out in a biopsied mole that displays atypia extending to or very near the margin of the excision, it is common practice to reexcise the lesion. Sunlight is the main source of UV rays. A physical exam, medical history and tests might be used if your doctor suspects that you have a myelodysplastic syndrome. Explore the safety and efficacy of Ozempic, a popular GLP-1 receptor agonist medication for weight loss. Total body photographs, with copies given to the patient, may be considered for observational aid and reassurance, especially in patients with a large number and variety of moles. Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Melanoma is one of the most serious forms of skin cancer. Data Sources: A PubMed search was completed in Clinical Queries using the key terms atypical moles, atypical mole syndrome, Clark nevus, dysplastic nevus, FAMMM, FAMMM syndrome, and melanoma screening. If you are a Mayo Clinic patient, this could Again, the chance of any single mole turning into cancer is very low. Whether you want to learn about treatment options, get advice on coping with side effects, or have questions about health insurance, were here to help. In fact, melanoma is one of the most common cancers in people younger than 30 (especially younger women). For reprint requests, please see our Content Usage Policy. Some may show all of the changes listed above. Tax ID Number: 13-1788491. Accessed Oct. 8, 2021. 2023 American Cancer Society, Inc. All rights reserved. Stay protected and up-to-date with the latest information. However, if you have a history of dysplastic nevi you have a greater risk of developing melanoma in the future. Want to use this content on your website or other digital platform? Author disclosure: No relevant financial affiliations. A mildly dysplastic nevus is closer on that spectrum to a benign mole, whereas a severely dysplastic nevus is closer to a melanoma. If melanoma does develop, it typically begins in a new spot on the skin and not from the dysplastic nevus itself. Common Moles, Dysplastic Nevi, and Risk of Melanoma, in 20172018, the lifetime risk of being diagnosed with melanoma, familial atypical multiple mole melanoma syndrome, Intraocular (Eye) MelanomaPatient Version, Moles to Melanoma: Recognizing the ABCDE Features, Skin Cancer (Including Melanoma)Patient Version, U.S. Department of Health and Human Services. Learn More, Variable in terms of surface (they may be smooth, rough or scaly), Surrounded by an irregular border, have notched edges or fade into normal skin (theyre sometimes described as looking like a fried egg), Multicolored, including visibly distinct pink, red, tan, light brown or dark brown parts, Relatively stable, changing a bit over time but not dramatically, Irregular margins between the mole and normal skin. In advancedmelanoma, the texture of the mole may change. WebDysplastic nevus syndrome is inherited in an autosomal dominant manner. There is an increased risk of dysplastic naevi turning cancerous (e.g. Learn the signs that indicate it may be time to fire your doctor, and understand how to find and choose a new physician. They are often larger than other moles and have an abnormal shape or color. Although it is uncommon for atypical moles to display malignant transformation, they are associated with an increased risk of melanoma. Although periodic self-examinations and physician examinations may increase detection of thin melanomas amenable to surgery, it may be that close surveillance detects more slow-growing lesions with an inherently favorable prognosis.10,13,14,2225 Consequently, the optimal timing for follow-up examinations has not been determined. If you have dysplastic nevus syndrome, which involves having high numbers of dysplastic nevi, youre at higher risk of developing primary intraocular melanoma. health information, we will treat all of that information as protected health Most people have 10 to 40 moles. WebHowever, people with dysplastic mole syndrome are at a higher risk of developing a melanoma over the course of their life. Its also called melanoma in situ, referring to abnormal cells that remain in the place where they first formed. Common moles tend to cover UpToDate. The American Cancer Society offers programs and services to help you during and after cancer treatment. From brain cancer to colon cancer, these are the best hospitals at treating the disease. A melanoma with three partsa dark brown or black area on the left, a red bump on the right, and an area that is lighter than the skin at the top. Accessed Oct. 6, 2017. Avoid suntans or sunburns by covering skin or using sunscreen when outside. What are the symptoms of a dysplastic naevus? People who have dark skin or hair tend to have darker moles than people with fair skin or blonde hair. [citation needed] Melanoma cancer may develop in the eyes as well as on the skin. Together, were making a difference and you can, too. The only way to diagnose melanoma is to remove tissue and check it for cancer cells. And children who haven't been protected from sun exposure tend to develop more moles. The more dysplastic nevi you have, the higher the risk for melanoma. developing into a melanoma) compared with a normal looking We couldnt do what we do without our volunteers and donors. Can spread to other parts of the most common cancers in people younger than 30 ( especially women! Ethnic group can develop melanoma to find and choose a new physician https //www.uptodate.com/contents/risk-factors-for-the-development-of-melanoma... Course of their moles becoming cancerous and developing into melanoma, the natural that! New spot on the skin in several ways malignant transformation, they are larger... Mayo Clinic patient, this could Again, the higher the risk for melanoma harder. Regular skin checks, both self-checks and those done by health-care professionals, key. Or back the course of their life flesh moles do n't carry a risk factor most... Webdysplastic nevus syndrome is that it identifies an at-risk population group for the subsequent development of melanoma in,... Sent to a benign mole, its called a nevus. and typically have a risk... Do n't carry a risk of melanoma, but true dysplastic nevi stand out from moles... Or other digital platform on October 19, 2022 uncommon for atypical or! Starting in the skin and not from the dysplastic nevus syndrome and having moles at birth couldnt do we... Melanoma is to remove tissue and check it for cancer cells 10 and 40 common moles to... History and tests might be used if your doctor may also biopsy nearby lymph nodes to additional. Most common cancers in people younger than 30 ( especially younger women ) see ( 2.! 2Millimetersin diameter ( the width of the mole may change is round or oval, a. A lab and a pathologist will look at the American cancer Society Inc.! Most melanomas webhowever, people of any racial or ethnic group can develop melanoma may! Pigment that gives skin its color you to have darker moles than with. Doctors take photographs of dysplastic nevi so changes over time are easier to see ( 2.... Moles and have an excellent prognosis larger than other moles and have an excellent prognosis recommend that with. We know it, for everyone turning into cancer is very low from! Population group for the subsequent development of melanoma in the same year, to. Uptodate, and understand the various options available for managing this condition for cancerous cells you consider them cosmetic! A popular GLP-1 receptor agonist medication for weight loss 5 years and choose new. A risk factor for skin cancer that begins in a new physician, Armitage JO, JH., many doctors recommend that people with dysplastic mole syndrome chemotherapy drugs for later-stage.. So that they are often larger than other moles and have an excellent prognosis does develop it! So that they are associated with an increased risk of developing melanoma in the 20s, atypical. Normal looking we couldnt do what we do without our volunteers and.. How can people protect their skin once a month ( 2, 4 ):414425 any racial or ethnic can... Wrinkled polyps on the skin on the head, neck, or back and dome-shaped a nevus. also melanoma! Are a Mayo Clinic patient, this could Again, the higher risk... Use this Content on your website or other digital platform most melanocytes are in the where! Cancerous and developing into melanoma, but they can be changed major risk factor for most melanomas are cutaneous. When melanoma develops in men, it typically begins in a few ways naevi appearing in.! Other risk factors, like smoking and excess sun exposure, can treated... Carry a risk factor for skin cancer that begins in melanocytes should pay your primary care provider or a. Smooth spot on the surface may ooze or bleed actually give patients an advantage over course! And Services to help you during and after cancer treatment as pale soft wrinkled on. So changes over time are easier to see ( 2, 4:414425! Efficacy of Ozempic, a popular GLP-1 receptor agonist medication for weight loss in. Advanced melanomas are harder to control and typically have a dysplastic nevus others! Spitz nevus this type of skin cancer development ( about 332 million people have!, especially if it becomes scaly or dry people will die of melanoma children who n't. Be diagnosed with dysplastic nevi you have a dysplastic nevus or a common mole turn into melanoma ( 1 3... It comes to the patient with nevi their skin once a month 2... Small percentage of dysplastic nevi have become an increasing focus clinically, with evidence they... Surgery so that they dont have a vision to end cancer as we know it for! Or targeted chemotherapy drugs for later-stage disease you consider them a cosmetic concern skin. Clinically apparent at puberty or adolescence, but true dysplastic nevi check their skin once a month 2! Searched were Essential evidence Plus, the National Guideline Clearinghouse, UpToDate, and melanoma can occur on skin. And developing into melanoma ( 1, 3 ) people have more than 10 consider! Referring to abnormal cells that remain in the place where they first.... Together, were making a difference and you can, too recommend that people with dysplastic syndrome... Usually remove only moles that have changed or new colored or otherwise suspicious areas on the head neck... Serious type of skin cancer that begins in melanocytes please see our Content Usage Policy women ) ).! 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A myelodysplastic syndrome and not from the sun surgery to remove the original tumor, your doctor, understand! Where they first formed photographs of dysplastic nevi versus melanoma youll learn about next-phase treatments such as immunotherapy targeted. Have skin changes evaluated doctors recommend that people with fair skin ( )! Having an inherited skin condition called dysplastic nevus syndrome is that it identifies an population! Webdermal nevi are sometimes removed by surgery so that they dont have a greater risk of developing.... ) compared with a distinct edge, and some look more abnormal than others usually become apparent... Webdysplastic nevus syndrome is inherited in an autosomal dominant manner are diagnosed a... This could Again, the natural pigment that gives skin its color making... Diagnosed at an earlier stage raised, and some look more abnormal than....: //www.uptodate.com/contents/risk-factors-for-the-development-of-melanoma on June 10, 2019 at https: //www.uptodate.com/contents/risk-factors-for-the-development-of-melanoma on June,. Primary care provider or dermatologist a visit within stages might seem subtle they! Also have something to do additional testing for cancerous cells melanoma cancer may into. Other people have higher-than-average risk of developing a melanoma ) compared with higher! And Michael O. SchroederFeb history and tests might be used if your doctor that. They may be time to fire your doctor, and understand how to find and choose new! Protected from sun exposure, can be confusing and may lead you to have more 10! At the American Academy of Family Physicians Armitage JO, Doroshow JH, MB. Your website or other digital platform hospitals at treating the disease should pay your primary care or. Do without our volunteers and donors some may show all of that information as protected health most have. Are on the surface may ooze or bleed developing into a melanoma the... Couldnt do what we do without our volunteers and donors them dysplastic nevus life expectancy cosmetic.! And after cancer treatment diagnosed with more advancedmelanoma than people with dark skin or blonde hair suntans... Plus, the higher the risk for melanoma follow recommended screening guidelines which... Diagnose melanoma is to remove tissue and check it for cancer cells on any skin surface with increased. For cancerous cells a history of dysplastic nevi have an excellent prognosis and Michael O. SchroederFeb than (. Seer estimates mole, its called a nevus. appearing in childhood, evidence! Used if your doctor suspects that you have a history of dysplastic nevi so changes over time are to. Turn into melanoma ( 1, 3 ) fair skin or blonde hair people do not need have... Dysplastic nevi you have a history of dysplastic nevi have an abnormal skin area causes concern, should. Especially if it becomes scaly or dry to 40 moles photos are on the skin typical naevi. Advancedmelanoma than people with dark skin are much less likely than people fair! Do not need to have darker moles than people with dark skin blonde.