Melanoma at Arm's Length

Summary and Comment |
December 17, 2015

Melanoma at Arm's Length

  1. Hensin Tsao, MD, PhD

For predicting total body nevi count, it appears that the arm is the window to the whole.

  1. Hensin Tsao, MD, PhD

The benefit of population-based screening for melanoma has been somewhat of a controversial issue. Results of early studies showing reduced melanoma mortality following general population screening failed to stand up to longer-term scrutiny. Better-targeted screening of high-risk individuals is another approach but requires easily accessible methods for initial risk prediction. High total mole count is a known risk factor for melanoma, but counting the whole body is difficult and time-consuming; investigators recently looked at partial mole counts in specific anatomic regions to determine the best surrogate for total mole enumeration.

The investigators examined data on nevus count in 3694 healthy female Caucasian twins (mean age, 47) from a U.K. twin study to determine whether total body count (mean, 32 nevi; range, 0–514) correlated with the count in specific regions. The arm was the most predictive site of 17 sites tested. Women with more than 11 nevi on the arm were nine times more likely to have over 100 nevi on the whole body (odds ratio, 9.38; 95% confidence interval,: 6.71–13.11). These findings were replicated in data from a general Caucasian population that also included males. The investigators found that the total body nevi count declined steadily by about 4 nevi with each decade of life.


In terms of moles, it appears that the arm is the window to the whole. An arm mole count of 11 or more strongly correlates with a total mole count greater than 100, indicating elevated melanoma risk. Arm nevi count could be an easy marker of risk considered alongside other features such as complexion, hair color, and personal and family history of skin cancer.

Editor Disclosures at Time of Publication

  • Disclosures for Hensin Tsao, MD, PhD at time of publication Consultant / advisory board Lubax; WorldCare Clinical Equity Lubax Grant / Research support NIH; Department of Defense; American Skin Association; Piramal Editorial boards British Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)


Reader Comments (1)

DENIS HART Physician, Dermatology

Based on a follow-up interview with one of the study authors, it has been clarified that the correlation of the mole count of 11 or more on the "arm" with a total body mole count of 100 or more is not actually correct. The "arm" in the study actually was the upper extremity, not the anatomical arm (shoulder to elbow).

The use of the term "arm" for the upper extremity in a medical publication is unfortunate and misleading.

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