Clinical ABCDE rule for early melanoma detection

Eur J Dermatol. 2021 Dec 1;31(6):771-778. doi: 10.1684/ejd.2021.4171.

Abstract

Background: The ABCDE rule systematizes warning signs for malignant melanoma (MM).

Objectives: To evaluate whether the ABCDE signs are associated with early detection of MM.

Materials & methods: Based on a retrospective study over 11.5 years, we assessed whether ABCDE signs are associated with early diagnosis of MM.

Results: In total, 144 MM were included; 52 (36.1%) in situ and 92 (63.9%) invasive lesions. For 23.6%, the MM were first suspected by an individual other than a dermatologist. The "E sign" was significantly less frequent among in situ lesions (32.7% versus 50.0%; p = 0.044). Based on adjusted analyses, the probability of MM being first suspected by a non-dermatologist consistently increased with the number of ABCDE signs of the lesion, ranging from 8% for a neoplasm with no ABCDE signs to 32% for a lesion with five signs (OR = 1.6; 95% CI: 1.2-2.2; p = 0.004).

Conclusion: A higher number of ABCDE signs were associated with a greater chance of MM being first suspected by a non-dermatologist, but not in situ MM diagnosis. Relying on the ABCDE rule alone might result in missing early MM lesions.

Keywords: ABCDE rule; early detection; malignant melanoma (MM); non-dermatologist.

MeSH terms

  • Carcinoma in Situ / diagnosis
  • Carcinoma in Situ / pathology
  • Early Detection of Cancer / methods*
  • Female
  • Humans
  • Male
  • Melanoma / diagnosis*
  • Melanoma / pathology*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology*