Utility of lesion diameter in the clinical diagnosis of cutaneous melanoma

Arch Dermatol. 2008 Apr;144(4):469-74. doi: 10.1001/archderm.144.4.469.

Abstract

Objective: To determine the utility of the current diameter criterion of larger than 6 mm of the ABCDE acronym for the early diagnosis of cutaneous melanoma.

Design: Cohort study.

Setting: Dermatology hospital-based clinics and community practice offices. Patients A total of 1323 patients undergoing skin biopsies of 1657 pigmented lesions suggestive of melanoma.

Main outcome measure: The maximum lesion dimension (diameter) of each skin lesion was calculated before biopsy using a novel computerized skin imaging system.

Results: Of 1657 biopsied lesions, 853 (51.5%) were 6 mm or smaller in diameter. Invasive melanomas were diagnosed in 13 of 853 lesions (1.5%) that were 6 mm or smaller in diameter and in 41 of 804 lesions (5.1%) that were larger than 6 mm in diameter. In situ melanomas were diagnosed in 22 of 853 lesions (2.6%) that were 6 mm or smaller in diameter and in 62 of 804 lesions (7.7%) that were larger than 6 mm in diameter. Conclusion The diameter guideline of larger than 6 mm provides a useful parameter for physicians and should continue to be used in combination with the A, B, C, and E criteria previously established in the selection of atypical lesions for skin biopsy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Artificial Intelligence*
  • Biopsy
  • Carcinoma in Situ / diagnosis
  • Carcinoma in Situ / pathology
  • Cohort Studies
  • Dermoscopy / instrumentation*
  • Diagnosis, Computer-Assisted / instrumentation*
  • Diagnosis, Differential
  • Dysplastic Nevus Syndrome / diagnosis
  • Dysplastic Nevus Syndrome / pathology
  • Female
  • Humans
  • Image Processing, Computer-Assisted / instrumentation*
  • Keratosis / diagnosis
  • Keratosis / pathology
  • Male
  • Melanoma / diagnosis*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasm Staging
  • Nevus, Pigmented / diagnosis
  • Nevus, Pigmented / pathology
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • ROC Curve
  • Skin / pathology*
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology