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Moles to Melanoma: Recognizing the ABCDE Features

Before You Get Started

To make this resource as useful as possible, please make sure you review and understand the following information.

View Photographs

Please click on the images below to view examples of moles, dysplastic nevi, and melanoma.

About the Tool

The Moles to Melanoma Tool presents photographs in three main groups of pigmented lesions: common moles; dysplastic nevi (DN); and melanomas that arose from DN.

The DN section is subdivided into two broad categories: stable and fading, and evolving toward melanoma.

Each case series shows changes in an individual pigmented lesion over a number of years and across the spectrum of changes typically seen in U.S. melanoma-prone families. We include a description of the “ABCDE” features for each type of pigmented lesion (moles, DN, and melanomas). Although the “ABCDE” rules were made for identifying early melanoma, they can also be used to describe DN.

About the Study

For more information about the study from which these cases were identified, please go to: Clinical, Laboratory, and Epidemiologic Characterization of Individuals and Families at High Risk of Melanoma


  1. Tucker MA, Fraser MC, Goldstein AM, et al. Melanomas and dysplastic nevi: A natural history atlas. Cancer. 2002 Jun 15;94(12):3192-209.
  2. Tucker MA, Halpern A, Holly EA, et al. Clinically recognized dysplastic nevi: a central risk factor for cutaneous melanoma. JAMA: The Journal of the American Medical Association 1997; 277(18):1439–1444.


We thank the study participants for their many years of participation, their willingness to be photographed during skin examinations, and their generosity in allowing their pictures to be included in this resource.

We would also like to thank John Crawford and Mary King, NIH Clinical Center clinical photographers, for their expertise. The tool would not have been possible without the substantial commitment and cooperation of both the study participants and the clinical photographers.

Who is the Intended Audience?

The photographs in this tool show moles on the skin of participants enrolled in the NCI Familial Melanoma Study. This study only includes individuals in U.S. melanoma-prone families who are at high-risk of developing this form of skin cancer. As shown in Figure 1, Caucasians are at the highest risk of developing melanoma. To date, this study has not identified or enrolled any non-Caucasian families; therefore this tool does not provide images representative of other ethnicities.

Figure 1: Melanoma incidence by race/ethnicity in the U.S. Surveillance, Epidemiology and End Results Program 1975-2012
Graph showing the melanoma Incidence Rates per one hundred thousand people in the U.S. between 1975 and 2013. In that time period, caucasians were found to have developed melanoma at a higher rate compared to individuals of other races and ethnicities
Reference: Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, , based on November 2014 SEER data submission, posted to the SEER web site, April 2015
Data points are not included for clarity of presentation, but may be found at Figure 16.2.

Where can I find information on Skin Cancer in other Ethnicities?

Where can I find information about Non-Melanoma Skin Cancer?

This collection does not include any pictures of non-melanoma types of skin cancer (e.g. basal cell or squamous cell), since they arise from different cell types in the skin they look very different from melanoma. For information on those types of skin cancer, visit the following websites: National Cancer Institute - Skin Cancer (including Melanoma) & American Cancer Society - Skin Cancer Facts.



Search Results



  • The pictures used in this tool were taken over more than a 35-year period. They show moles and melanomas from participants enrolled in the NCI Familial Melanoma Study.
  • The pictures show examples of the variability in pigmented lesions in U.S. melanoma-prone families.
  • Because most of the study participants are Caucasian, the nevi and melanomas shown are not representative of those found in individuals with darker skin.
  • Melanomas and lesions suspicious for melanoma vary widely in appearance; these pictures should not be used to diagnose melanoma.
  • NCI does not provide medical advice to users of its website.
  • Consult with a qualified health care provider if you have concerns about your skin.

About the photos

  • The photographs have variations in color due to differences in photography equipment, lighting, and skin color of the individual (e.g. sunburned or suntanned).
  • Photographs are standardized to ease viewing.
  • Rulers show size of the moles and melanomas in millimeters.