Novice identification of melanoma: not quite as straightforward as the ABCDs

Acta Derm Venereol. 2011 Mar;91(2):125-30. doi: 10.2340/00015555-1070.


The "ABCD" mnemonic to assist non-experts' diagnosis of melanoma is widely promoted; however, there are good reasons to be sceptical about public education strategies based on analytical, rule-based approaches--such as ABCD (i.e. Asymmetry, Border Irregularity, Colour Uniformity and Diameter). Evidence suggests that accurate diagnosis of skin lesions is achieved predominately through non-analytical pattern recognition (via training examples) and not by rule-based algorithms. If the ABCD are to function as a useful public education tool they must be used reliably by untrained novices, with low inter-observer and intra-diagnosis variation, but with maximal inter-diagnosis differences. The three subjective properties (the ABCs of the ABCD) were investigated experimentally: 33 laypersons scored 40 randomly selected lesions (10 lesions × 4 diagnoses: benign naevi, dysplastic naevi, melanomas, seborrhoeic keratoses) for the three properties on visual analogue scales. The results (n = 3,960) suggest that novices cannot use the ABCs reliably to discern benign from malignant lesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Decision Making*
  • Dysplastic Nevus Syndrome / diagnosis
  • Female
  • Humans
  • Keratosis, Seborrheic / diagnosis
  • Learning*
  • Male
  • Melanoma / diagnosis*
  • Middle Aged
  • Pattern Recognition, Visual*
  • Skin Neoplasms / diagnosis*
  • Students
  • Young Adult