At ISO Skin Cancer Clinic, we prioritise early detection and risk assessment for melanoma, particularly for high-risk individuals. A 29-year-old patient with Fitzpatrick type 3 skin, a strong family history of melanoma, and over 100 moles, presents a significantly elevated risk of developing melanoma compared to the general population.
This article will provide a fact-based analysis of her risk factors, recommended skin check intervals, mole assessments, and her child’s and husband’s risks, based on the latest dermatological research and guidelines.
What Is My Risk of Developing Melanoma Compared to the Average Person?
Fact Check: Your Risk Is Significantly Higher Than Average
Based on clinical data, individuals with:
- More than 100 moles (naevi) have a seven-fold higher risk of melanoma compared to those with fewer than 15 moles.
- A first-degree relative with melanoma (such as a mother or sibling) have double the risk of developing melanoma.
- A family history of dysplastic naevus syndrome (as in this case) may further increase risk, as individuals with this syndrome often have atypical moles that are more likely to transform into melanoma.
Statistical Perspective
- Baseline melanoma risk in the general population: Approximately 1 in 14 for men and 1 in 22 for women in the UK.
- This patient’s estimated risk: At least 7 to 14 times higher than the average person due to the combination of high naevus count and family history.
How Often Should I Have a Skin Examination?
Guidelines for High-Risk Individuals
- Every six months: High-risk individuals (RR ≥ 5) should undergo six-monthly full-body skin examinations.
- Total Body Photography (TBP) and Dermoscopy: This helps track changes over time.
- Self-Examinations: Monthly self-checks can improve early detection.
Lifetime surveillance is recommended, as recurrences can happen decades after initial melanoma diagnosis.
Are Any of My Moles at a Significantly Higher Risk of Melanoma?
While all moles contribute to overall melanoma risk, some individual moles are more suspicious than others.
High-Risk Features of Moles (ABCDE Rule)
- A – Asymmetry: One half does not match the other.
- B – Border: Irregular or poorly defined edges.
- C – Colour: Multiple colours (brown, black, red, white, blue).
- D – Diameter: Greater than 6mm.
- E – Evolving: Changes in size, shape, colour, or texture over time.
The Role of Terminal Hairs in Moles
- Moles with terminal hairs are NOT necessarily at higher risk for melanoma.
- Moles that change, lose hair, or develop irregular pigmentation should be monitored closely.
Are Larger Moles at Greater Risk Than Smaller Moles?
Larger Moles Carry a Higher Risk
- Moles larger than 6mm are more likely to develop into melanoma, though size alone is not a definitive risk factor.
- Atypical moles (dysplastic naevi), which are often larger than regular moles, carry a higher risk of melanoma transformation.
Regular dermoscopic assessment is recommended to differentiate between benign large moles and high-risk lesions.
Will You Excise Any of My Moles if They Show Signs of Severe Dysplasia?
Yes, any mole displaying dermatoscopic signs of severe dysplasia or early melanoma changes should be excised.
Dermatoscopic Features of Severely Dysplastic Moles
- Irregular pigment network.
- Blue-white veil (suggestive of deep melanocytic activity).
- Asymmetric structure with chaotic patterns.
- Vascular abnormalities, such as polymorphic or dotted vessels.
If a mole shows suspicious changes, excision biopsy is necessary for histopathological evaluation.
Is My 7-Year-Old Son at Increased Risk for Melanoma?
Children with a Family History of Melanoma
- Children with a first-degree relative who had melanoma have double the risk of developing it.
- The more family members affected, the greater the risk.
When Should My Son Start Skin Checks?
- Early childhood education: Teach sun safety and self-examination awareness.
- Routine checks from age 10–12: Start professional dermatological assessments, unless suspicious lesions appear earlier.
- Monitor mole development: If he has multiple moles or atypical naevi, start skin checks earlier.
Does My Japanese Husband Have a Higher Risk for Melanoma on His Soles?
Fact Check: Yes, Asians Have Higher Risk for Acral Lentiginous Melanoma (ALM)
- Acral Lentiginous Melanoma (ALM) is the most common melanoma subtype in Asians.
- It often appears on the palms, soles, or under the nails, areas not typically exposed to the sun.
- Unlike other melanomas, ALM is NOT strongly linked to UV exposure.
How Often Should He Get His Feet Checked?
- Annual foot and nail examinations for early detection.
- Self-checks for dark streaks or changes under the toenails, palms, or soles.
- Dermoscopic analysis for high-risk lesions.
Key Takeaways: Skin Cancer Prevention at ISO Skin Cancer Clinic
- This patient has a significantly higher melanoma risk due to:
- More than 100 moles (7x risk).
- Family history of melanoma (2x risk).
- Potential dysplastic naevus syndrome.
- Skin examination frequency:
- Six-monthly full-body skin checks with dermoscopy and total body photography.
- Self-checks every month for new or changing moles.
- Children with a melanoma family history should start skin checks at an early age, especially if they develop numerous moles.
- Asians have a higher risk for Acral Lentiginous Melanoma (ALM), which can develop on soles, palms, and nails. Routine foot exams are crucial.
Book Your Skin Check at ISO Skin Cancer Clinic Today
At ISO Skin Cancer Clinic, we provide:
✅ Advanced Dermoscopic Screening.
✅ Expert Melanoma Risk Assessments.
✅ Comprehensive Family Risk Evaluations.
Don’t wait for symptoms—early detection saves lives! Book your consultation today.
