Early recognition of melanoma is an important
prognostic factor. To distinguish early melanoma from other forms of benign
pigmented lesions, we can use the ABCDE rule.
- Asymmetry
(if a lesion is bisected, one half is not identical to the other half)
- Border
irregularities
- Color
variegation (brown, red, black or blue/gray, and white)
- Diameter ≥6
mm
- Evolving: a
lesion that is changing in size, shape, or color, or a new lesion
The diagnostic accuracy of the ABCD vary in
different studies. In a retrospective study of 1140 lesions including 460
melanomas, the sensitivity in identifying a lesion as a melanoma was 97 percent
when using a single criterion and 43 percent when using all five criteria
jointly. By contrast, specificity was 36 percent for a single criterion and 100
percent for all five criteria.
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