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Skin exam

A skin exam is sometimes called a total body skin exam. It allows your doctor or other trained health professional to look for any signs of skin cancer or abnormal areas of skin. Getting regular and thorough skin exams can help find skin cancer early.

Who should have a skin exam

A skin exam is often done as part of a yearly health checkup.

People who have a higher risk of developing skin cancer may need to be examined more often than people with average risk. Talk to your doctor about a personal plan for skin exams. These are some factors that could put you at higher risk of developing skin cancer:

  • a personal history of skin cancer, including actinic keratosis (a precancerous condition of the skin)
  • light-coloured skin, eyes and hair
  • many moles or freckles
  • having had several blistering sunburns as a child
  • having had PUVA therapy for psoriasis

How a skin exam is done

During a skin exam, the health professional will systematically check the entire surface of your skin, especially areas of skin exposed to the sun. They will look for any signs of skin cancer.

About 85% of non-melanoma skin cancers develop on areas of the body that are often exposed to the sun. But 20% of melanomas occur on skin that isn’t always exposed to the sun. That is why it is important to check all of your skin. Make sure that you take off all makeup before you have a skin exam.

Health professionals use the following systems to help them assess a mole.

ABCDE rule

The ABCDE rule helps health professionals assess different features to tell a normal mole from skin cancer.

A is for asymmetry. One-half of a mole does not have the same shape as the other half.

B is for border. The edge of a mole is uneven (irregular). It can look jagged, notched or blurry. The colour may spread into the area around the mole.

C is for colour. The colour of a mole is not the same throughout. It could have shades of tan, brown and black. Sometimes areas of blue, grey, red, pink or white are also seen.

D is for diameter. The size of a mole is larger than 6 mm across, which is about the size of a pencil eraser.

E is for evolving. There is a change in the colour, size, shape or feel of the mole. The mole may become itchy or you may have a burning or tingling feeling.

7-point checklist

The 7-point checklist may be used to help health professionals find changes that may be skin cancer. It looks for 7 specific features in a mole or coloured area of skin. Each feature that is found is given 1 or 2 points depending on the type of feature. If a mole or coloured area scores 3 or more points, you are referred to a specialist or sent for more tests. The features are divided into 2 groups – major features and minor features.

Major features (2 points each):

  • change in size
  • uneven (irregular) colour
  • uneven shape

Minor features (1 point each):

  • more than 7 mm in diameter
  • changes in feeling, such as itchiness, tenderness or pain
  • oozing or crusting
  • inflammation or bleeding

What happens if an abnormal area is found

If a health professional notices an abnormal area during a skin exam, they will decide if you should have further tests. You may be referred to a specialist, such as a dermatologist or plastic surgeon. A skin biopsy may be done to check for cancer.

biopsy

The removal of cells or tissues for examination under a microscope.

Different types of biopsies include incisional biopsy, excisional biopsy and needle biopsy. Sometimes imaging techniques are used to guide the biopsy, as in ultrasound-guided biopsy and computed tomography (CT)–guided biopsy.

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