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A Confusing Message Will Not Improve the Detection of Melanoma

A Confusing Message Will Not Improve the Detection of Melanoma The intent of Liu and her associates1 to define the time available to detect melanoma to improve the treatment of this cancer is admirable. Unfortunately, their recommendations do not advance that aim. They recommend that special attention be given to promote awareness that rapidly growing melanomas are symmetrical, have regular borders, and lack pigment. This message is directly opposite to the one our profession has been teaching the public for the past 2 decades (the ABCD rule—A, asymmetry; B, border irregularity; C, color variegation; D, diameter >5 mm): that the warning signs of melanoma lesions are pigmentation, asymmetrical shape, and irregular borders. Promoting public awareness that lesions of concern can be pigmented or not, symmetric or asymmetric, and have regular or irregular borders sends a confusing message that is difficult to follow. The signs highlighted by Liu et al1 do draw attention to the small subset of nodular melanomas that grow rapidly. But highlighting these features unfortunately draws attention away from the majority of melanomas that have the opposite features. One way to capture the most critical feature of rapidly growing melanomas without changing the focus of our message is to simply add the letter E, for enlarging, to the ABCD rule, as recently recommended.2 Correspondence: Dr Bystryn, Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 550 First Ave, TH313, New York, NY 10016 (Bystryn@nyu.edu). Financial Disclosure: None reported. References 1. Liu WDowling JPMurray WK et al. Rate of growth in melanoma: characteristics and associations of rapidly growing melanomas Arch Dermatol 2006;1421551- 1558PubMedGoogle Scholar 2. Abbasi NRShaw HMRigel DS et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA 2004;2922771- 2776PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

A Confusing Message Will Not Improve the Detection of Melanoma

Archives of Dermatology , Volume 143 (6) – Jun 1, 2007

A Confusing Message Will Not Improve the Detection of Melanoma

Abstract

The intent of Liu and her associates1 to define the time available to detect melanoma to improve the treatment of this cancer is admirable. Unfortunately, their recommendations do not advance that aim. They recommend that special attention be given to promote awareness that rapidly growing melanomas are symmetrical, have regular borders, and lack pigment. This message is directly opposite to the one our profession has been teaching the public for the past 2 decades (the ABCD rule—A,...
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References (2)

Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.143.6.806-a
pmid
17576958
Publisher site
See Article on Publisher Site

Abstract

The intent of Liu and her associates1 to define the time available to detect melanoma to improve the treatment of this cancer is admirable. Unfortunately, their recommendations do not advance that aim. They recommend that special attention be given to promote awareness that rapidly growing melanomas are symmetrical, have regular borders, and lack pigment. This message is directly opposite to the one our profession has been teaching the public for the past 2 decades (the ABCD rule—A, asymmetry; B, border irregularity; C, color variegation; D, diameter >5 mm): that the warning signs of melanoma lesions are pigmentation, asymmetrical shape, and irregular borders. Promoting public awareness that lesions of concern can be pigmented or not, symmetric or asymmetric, and have regular or irregular borders sends a confusing message that is difficult to follow. The signs highlighted by Liu et al1 do draw attention to the small subset of nodular melanomas that grow rapidly. But highlighting these features unfortunately draws attention away from the majority of melanomas that have the opposite features. One way to capture the most critical feature of rapidly growing melanomas without changing the focus of our message is to simply add the letter E, for enlarging, to the ABCD rule, as recently recommended.2 Correspondence: Dr Bystryn, Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 550 First Ave, TH313, New York, NY 10016 (Bystryn@nyu.edu). Financial Disclosure: None reported. References 1. Liu WDowling JPMurray WK et al. Rate of growth in melanoma: characteristics and associations of rapidly growing melanomas Arch Dermatol 2006;1421551- 1558PubMedGoogle Scholar 2. Abbasi NRShaw HMRigel DS et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA 2004;2922771- 2776PubMedGoogle ScholarCrossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 2007

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