BE AWARE of "Ugly Duckling" Moles, They May Be Skin Cancer

According to a new study, published in the journal Archives of Dermatology, many irregular pigmented moles may not be correctly identified as skin melanomas. The study showed that irregular pigmented moles, known as "ugly duckling," are usually misdiagnosed as benign lesions while in reality they are likely to be malignant skin melanomas (skin cancer).

More specifically, Dr. Marghoob and colleagues, from the Memorial Sloan-Kettering Cancer Center, reported in their study that only 66% of the hospital staff was able to correctly identify 5 melanomas from 140 benign lesions presented to them.

Experts believe that irregular moles, known also as nevi, are on of the key risk factors for skin cancer detection and prevention so a careful examination of such nevi is essential for proper cancer prevention.

The big issue for hospital staff who works in the area of dermatology is to identify successfully the skin lesions that are malignant and to differentiate them from those that are not. This issue of skin lesion differentiation requires carefully and extensive training that in some cases doctors does not receive or have.

To complicate the matter is the fact that there is an area of overlap in the moles' clinical features that favors the misdiagnosis of malignant lesions as benign ones, researchers of the study stated.

In this study, 34 hospital staff members were subjected to trial in which the concept of "ugly duckling" was put to the test. The ugly duckling concept states that skin lesions (in the same person) tend to be similar from one to another and those that may seem similar may be malignant ones and often misdiagnosed.

These 34 staff personnel were able to examine clinical images of 12 patients. All 12 patients who participated in this study had at least 8 irregular moles on the back. Five of those 12 patients had one of the lesions confirmed (by laboratory tests) as melanoma lesions. Participants evaluated whether the images were malignant or benign ones.

Only 66% of the hospital staff, which included lesion specialists, general dermatologists, dermatology nurses, and members of the no clinical staff, was able to correctly identify 5 melanomas from 140 benign lesions presented to them. As expected the sensitivity of the detection decreased as the extension and period of training was shorter within the participants of this study

Study as this one shows the importance of training in an area of the medical practice in which there is the possibility of diagnosing incorrectly health issue. Medical school and hospital need to put more emphasis in education and training of its medical staff to avoid complication for patients.

Source:

Marghoob et al. 2008. The "Ugly Duckling" Sign. Arch Dermatol. 2008;144(1):58-64