TranscriptDr. Mayzik The first step in diagnosing skin cancer is a thorough skin examination by a provider. Dr. Alvarado, can you tell us what’s involved in a skin exam? Dr. Alvarado Sure, Dr. Mayzik. During a skin exam, the provider will record the color, size, shape, and texture of any suspicious areas, and determine if there is any bleeding, oozing, or crusting. Spots or moles on other parts of the body may also be checked. Because skin cancer can occur anywhere, including the genitals and other sensitive areas, a skin exam is not the time for modesty. The provider may recommend not wearing make-up during the skin exam, as make-up can interfere with the ability to examine suspicious areas clearly. Some providers use a dermatoscope, which is a special magnifying lens and light source, to help see spots on the skin more clearly. This test is called a dermoscopy, but you may also hear it referred to as dermatoscopy, surface microscopy, or epiluminescence microscopy, or ELM. In some cases, a thin layer of alcohol or oil may be applied to the skin, and the provider may take a digital photo of the spot or growth. The provider may also feel the lymph nodes under the skin near the suspicious area. When skin cancer spreads to the lymph nodes, the lymph nodes may become larger and firmer than usual.