A series of melanomas smaller than 4 mm and implications for the ABCDE rule

Sm, Goldsmith; Solomon, A. R.

doi:10.1111/j.1468-3083.2006.02115.x

Cited by 33 publications

(44 citation statements)

References 19 publications

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“…The parameters asymmetry, border irregularity, color (multiple colors), and diameter larger than 6 mm are used globally in medical education and in the lay press to provide simple parameters for evaluation of pigmented skin lesions which may require a more comprehensive examination by a specialist. While the A, B, and C criteria have been widely accepted, the emergence of reports with a significant proportion of melanomas with a diameter < 6 mm [15,16], has generated controversy around the criterion D, questioning its usefulness in recognizing incipient lesions. In our study, the vast majority of the melanomas that led to patient’s consultation (MMC) fulfilled the 4 ABCD criteria with a 97% of lesions with a diameter > 6 mm.…”

Section: Discussionmentioning

confidence: 99%

The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas

Salerni

Terán

Alonso

et al. 2014

Dermatol Pract Concept

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Background:Early recognition is the most important intervention to improve melanoma prognosis.Objective:To report the value of dermoscopy and digital dermoscopy in the clinical diagnosis of malignant melanoma (MM).Methods:Retrospective analysis of 99 consecutive primary MMs diagnosed between 2010 and 2013. The MMs were divided into 3 groups: 1) the MM was the reason for consultation (MMC), 2) the MM was detected during routine control of nevi (MMRC), and 3) the MM was detected due to changes observed during digital dermoscopy follow-up (MMDFU). Clinical, dermoscopic and histologic features were assessed.Results:A total of 99 MMs were diagnosed in 89 patients (55% male) with a mean age of 50.8 (18-93) years. Of all the MMs, 35 were the reason for patient consultation (MMC), 52 were detected during routine control of nevi (MMRC) and 12 were diagnosed due to changes observed with digital dermoscopy (MMDFU). On clinical examination, 74.2 % of MMC met the 4 ABCD criteria, while only 30.7 % of MMRC and 8.3 % of MMDFU. Most MMC were correctly classified as malignant according to dermoscopy, but 44.2% of MMRC and only 16.7% of MMDFU. 22.9% of MMC, 50% of MMRC and 58.3% of MMDFU were in situ. Mean Breslow thickness was significantly lower in the MMDFU group (0.52 mm) than in the MMRC and MMDFU groups (0.77 and 1.43 mm respectively).Conclusions:The use of dermoscopy and digital dermoscopy allows the detection of MMs in early stages, even in the absence of specific criteria for malignancy.

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Section: Discussionmentioning

confidence: 99%

The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas

Salerni

Terán

Alonso

et al. 2014

Dermatol Pract Concept

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“…In a case series by Kamino et al, 38 20% (4/20) of small melanomas (\6 mm) were darkly pigmented, however, Bergman et al 39 found this percentage to be significantly lower (3.5%; 4/112). The intensity of dark pigment has been noted as a clinical characteristic in small melanomas less than 4 mm, 40 and Helsing and Loeb 27 indicated that darker color change was a more frequent observation among small melanomas (\7 mm), compared with nonsmall melanomas. Patient perceptions of presenting features for 92 SSM and 33 nodular melanomas indicated that the predominant color of SSM was dark brown (37.8%) followed by black (26.7%) and light brown (17.8%), and the predominant color of nodular melanoma was pink (33.3%) followed by black (24.3%) and red (21.2%).…”

Section: Use Of the Diameter (D) Criterionmentioning

confidence: 98%

Early detection of melanoma: Reviewing the ABCDEs

Tsao

Olazagasti

Cordoro

et al. 2015

Journal of the American Academy of Dermatology

162

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“…The clinical ABCDE rule fails to recognise MMs that are small (less than 6 mm in diameter) or that exhibit regular shape and homogeneous colour, are symmetrical or undergo unnoticed changes (10,11). Dermoscopy is now well accepted as a non-invasive technique that improves the accuracy of skin tumour diagnosis (12)(13)(14), and is especially useful in the differential diagnosis of MM simulators or hypopigmented MM, avoiding unnecessary excisions (15)(16)(17).…”

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confidence: 98%

Early Stages of Melanoma on the Limbs of High-risk Patients: Clinical, Dermoscopic, Reflectance Confocal Microscopy and Histopathological Characterization for Improved Recognition

Carrera¹,

Palou²,

Malvehy³

et al. 2011

Acta Derm Venerol

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Early stages of 36 melanomas on limbs were morphologically characterised. Most occurred in high-risk patients (multiple and/or familial melanoma) attending a referral unit for melanoma and pigmented lesions. None of the tumours was clinically suspicious for melanoma (mean diameter of 4.3 mm). The tumours were classified into four dermoscopic groups: (i) prominent network (n = 16); (ii) delicate network (n = 5); (iii) hypo-pigmentation with dotted vessels (n = 10); and (iv) diffuse light pigmentation with perifollicular pigmentation (n = 5). Confocal microscopy performed in 12 cases allowed the identification of atypical, single cells within epidermal layers. Histopathology showed marked large atypical cells in a pagetoid spreading pattern in most cases. Significant associations were detected between the third dermoscopic group and naevoid histological appearance and delay in detection, and between the fourth group and lentigo-maligna-like features. Dermoscopy allowed an increase in the suspicious threshold in these difficult melanomas in high-risk patients and enabled the subclassification of early melanomas on the limbs, with a correct confocal and histopathological correlation. Although the biological behaviour of these incipient tumours remains uncertain, the most appropriate treatment seems to be recognition and proper excision.

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A series of melanomas smaller than 4 mm and implications for the ABCDE rule

Cited by 33 publications

References 19 publications

The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas

The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas

Early detection of melanoma: Reviewing the ABCDEs

Early Stages of Melanoma on the Limbs of High-risk Patients: Clinical, Dermoscopic, Reflectance Confocal Microscopy and Histopathological Characterization for Improved Recognition

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