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The Signs of Melanoma, One of the Most Dangerous Skin Cancers

by James P. Johnston, D.O.

I've had to leave town recently a loved one was having a major surgery for a malignant melanoma. I saw the suspicious skin lesion over the Christmas holidays and urged the relative to get it removed. Thank God, a biopsy was performed and removed today before it grew too much. (This out-of-town trip and my recent move is one of the reasons I'm a little tardy getting through my Things-To-Do list recently, so if I told you I was going to do something for you, whether it's a consult letter or a lab order or a school note, be patient with me. I'll get to it. One patient recently quit my practice because I was a week and a half late with sending them a lab order. That's not that long of a wait for a routine lab order! Please be patient and text me if I told you I would do something for you and haven't yet.)

One of the perks of my family practice is I do most my patients' dermatology. I took off a large melanoma off a patient a few months ago, and as soon as I saw the biopsy report, I consulted a dermatologist for a wide excision of the area to reduce the chances of recurrence. At no extra charge, I can save you some significant expense and some treatment delay and take off suspicious lesions in the comfort of your home. Make a two hour appointment if you have something you'd like me to look at and possibly remove.

While basal cell cancers or squamous cell cancers are more common and relatively easy to remove, malignant melanomas are more likely to cause death and disability because they can metastasize relatively quickly. So it is important to be aware of what to look for, especially if you're sensitive to the sun or you have a family history of melanoma.

Changes in the size, shape, color, or feel of a skin lesion are often the first warning signs of melanoma. These kinds of changes can occur in an existing mole or skin lesion, or melanoma may appear as a new or unusual-looking mole or spot. The "ABCDE" rule is helpful in remembering the warning signs of melanoma:

  • Asymmetry. If the shape of one-half of the skin lesion does not match the other half, this increases suspicion for melanoma.

  • Border. If the edges of the skin lesion are ragged, notched, uneven, or blurred, that increases suspicion.

  • Color. Shades of black, brown, and tan may be present. Areas of white, gray, pink, red, or blue may also be seen. The darker it is, the more suspicious it is. And the less uniform and more diverse in color it is, the more suspicious it is.

  • Diameter. If the diameter is larger than 6 millimeters or it has grown in size, the greater the suspicion for melanoma.

  • Evolving. If the mole or lesion has been changing in size, shape, color, or appearance, or it is growing in an area of previously normal skin, that increases suspicion. Also, when melanoma develops in an existing mole or lesion, its texture may change and become hard or lumpy. The mole or lesion may feel different and may itch, ooze, or bleed, but a melanoma skin lesion usually does not cause pain.

I have removed suspicious lesions that met almost none of these criteria, and surprisingly turned out to be a melanoma. So when it doubt, make an appointment and I will take a look at your skin and biopsy or excise any suspicious skin lesion.

Respectfully submitted,

James P. Johnston, D.O.


If when you try to make an appointment, the website asks you to pay again, go back to the home page and click the "log in" icon at the top of the page. If you log in again, and it still asks you pay, your credit card or bank has refused payment for some reason. Get that squared away with your bank, and contact Dr. Johnston about renewing medical services.

On Mondays and on Thursdays, you can make an appointment with D r. Johnston or with his Nurse Practitioner Kaitlyn Barnett. To specify, click "staff member". Then pick your provider from the pull down menu.

Contact Dr. Johnston through the website if you have any problems.



There's an uptick in COVID infections. There's some prediction that another lockdown is coming. Another vaccine mandate and another mask mandate.

Most people have some immunity to previous infections, and so that's their best friend against the next pandemic. But this pathogen mutates quickly and some people will get reinfected. And the COVID swab tests are notoriously inaccurate.

So if you have significant morbidities that increase your risk of a negative outcome, make an appointment to discuss getting on prophylactic, biweekly Ivermectin or Hydroxychloroquine. (You may specify a phone appointment when you make the appointment.) If you don't have any comorbidities but would like a course of Ivermectin, text me your name, date of birth, and weight. I will call it into Dilworth Drugs in Charlotte and they'll contact you when its ready. They can even ship it to you if you're in North Carolina.

Recently, an attorney for the FDA admitted in court that it has always been permissible for physicians to be able to prescribe Ivermectin for COVID-19. (Snopes confirms this.) However, I know from a personal experience this is a lie. Twice doctors have complained to the N.C. Medical Board that I prescribed the non-FDA approved COVID treatment Ivermectin to their COVID-infected patients. Thank God, I won those cases, but I know many who've lost their licenses for prescribing Ivermectin or Hydroxychloroquine for COVID patients. Even so, the evidence is overwhelming that both Ivermectin & Hydroxychloroquine reduce the morbidity and mortality for COVID-19. In my opinion, the Frontline Critical Care COVID Physicians Alliance is still the best thinktank on this subject, and I would encourage you all to broadly disseminate their summary of the worldwide data proving Ivermectin prescribed for COVID-19 is both safe and effective. A link to share is found HERE. Or cut and paste the image below and share broadly. Thank you.

With the broad government-sponsored censorship designed to suppress the science on Ivermectin and Hydroxychloroquine, and promote the COVID vaccine in defiance of all the scientific evidence of its danger as well as its lack of efficacy, it's important that you each play a role in broadly disseminating this brief summary of the evidence.

Lastly, please share with friends and family, and on social media, the promotional video of my medical practice, found HERE. Thanks.

James P. Johnston, D.O.,

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