There are many lesions that can look like melanoma. Atypical nevi which are larger than normal nevi often times have an irregular pigment pattern. These lesions are common and are the lesion most frequently confused with melanoma.
Seborrheic keratoses can mimic melanoma. They can have deeply pigmented surfaces and irregular borders. The surface of seborrheic keratoses should be examined carefully with magnification for the characteristic findings of horn pearls and uniformity the surface. Patient’s are constantly suspicious that seborrheic keratoses are melanomas. Inflamed seborrheic keratoses present a diagnostic problem. These growths lose their characteristic surface findings and may be impossible to differentiate by clinical examination for melanoma. Therefore consider removing any irritated lesion suspicious for irritated seborrheic keratosis for histologic confirmation. Irritated lesions should not be treated with cryotherapy unless the clinical diagnosis of a benign lesion is made with certainty.