Limits...
A unifying approach to the clinical diagnosis of melanoma including "D" for "Dark" in the ABCDE criteria.

Goldsmith SM - Dermatol Pract Concept (2014)

Bottom Line: Current clinical approaches to melanoma diagnosis have not been associated with a decrease in mortality from this cancer.The components of the new approach presented are, first, a screening examination to look for any lesion that stands out because of being dark, different, or changing; second, when a single lesion is recognized to be of concern for any reason, that lesion is then evaluated in more detail utilizing the ABCDE criteria, with the "D" signifying "Dark" and not "6 mm Diameter" in this mnemonic; and, third, additional discussion of the "ugly duckling" sign and of the recognition of nodular melanomas.Since the Georgia Society of Dermatology and Dermatologic Surgery was the first state or national society to endorse this approach, I refer to it as the Georgia approach.

View Article: PubMed Central - PubMed

Affiliation: Dermatology, Emory University School of Medicine.

ABSTRACT
Current clinical approaches to melanoma diagnosis have not been associated with a decrease in mortality from this cancer. The components of the new approach presented are, first, a screening examination to look for any lesion that stands out because of being dark, different, or changing; second, when a single lesion is recognized to be of concern for any reason, that lesion is then evaluated in more detail utilizing the ABCDE criteria, with the "D" signifying "Dark" and not "6 mm Diameter" in this mnemonic; and, third, additional discussion of the "ugly duckling" sign and of the recognition of nodular melanomas. Since the Georgia Society of Dermatology and Dermatologic Surgery was the first state or national society to endorse this approach, I refer to it as the Georgia approach.

No MeSH data available.


Related in: MedlinePlus

The Georgia approach presented as a patient information card (actual card size is 8½ inches x 3½ inches). (Copyright: ©2014 Goldsmith et al.)
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4230266&req=5

f1-dp0404a16: The Georgia approach presented as a patient information card (actual card size is 8½ inches x 3½ inches). (Copyright: ©2014 Goldsmith et al.)

Mentions: The number of yearly deaths from melanoma continues to increase, and the overall melanoma mortality rate is one of the few cancer mortality rates not on the decline [1,2]. These realities combined with increasing evidence of the lack of efficacy of the ABCDE criteria have necessitated ongoing efforts to enhance the earlier clinical detection of melanoma [3–8]. Most approaches to melanoma diagnosis have included some predominant emphasis or combination of emphases on recognition of changing lesions, recognition of outlier (“ugly-duckling”) lesions, and specific melanoma characteristics, with the most utilized criteria being the ABCDE criteria (“A” for “Asymmetry,” “B” for “Border irregularity,” “C for Color variation,” “D for 6 mm Diameter,” and “E” for “evolving lesions”) [8]. Many recently published strategies have rejected the diameter criterion as well as abandoned all or portions of the ABCDE mnemonic [3,5,9–12]. Many of these proposed strategies, including the “D” for “Dark” proposal I offered, have also added emphasis on recognition of darkness as a particular feature of concern in pigmented lesions [5,10–12]. I have recently reviewed the compelling rationale for both an increased emphasis on darkness and rejection of the diameter criterion in the clinical diagnosis of melanoma [13]. The Georgia approach to melanoma diagnosis uniquely incorporates many elements of these strategies in a complementary manner to increase the sensitivity of diagnosis of early melanoma [13,14] (Figure 1).


A unifying approach to the clinical diagnosis of melanoma including "D" for "Dark" in the ABCDE criteria.

Goldsmith SM - Dermatol Pract Concept (2014)

The Georgia approach presented as a patient information card (actual card size is 8½ inches x 3½ inches). (Copyright: ©2014 Goldsmith et al.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4230266&req=5

f1-dp0404a16: The Georgia approach presented as a patient information card (actual card size is 8½ inches x 3½ inches). (Copyright: ©2014 Goldsmith et al.)
Mentions: The number of yearly deaths from melanoma continues to increase, and the overall melanoma mortality rate is one of the few cancer mortality rates not on the decline [1,2]. These realities combined with increasing evidence of the lack of efficacy of the ABCDE criteria have necessitated ongoing efforts to enhance the earlier clinical detection of melanoma [3–8]. Most approaches to melanoma diagnosis have included some predominant emphasis or combination of emphases on recognition of changing lesions, recognition of outlier (“ugly-duckling”) lesions, and specific melanoma characteristics, with the most utilized criteria being the ABCDE criteria (“A” for “Asymmetry,” “B” for “Border irregularity,” “C for Color variation,” “D for 6 mm Diameter,” and “E” for “evolving lesions”) [8]. Many recently published strategies have rejected the diameter criterion as well as abandoned all or portions of the ABCDE mnemonic [3,5,9–12]. Many of these proposed strategies, including the “D” for “Dark” proposal I offered, have also added emphasis on recognition of darkness as a particular feature of concern in pigmented lesions [5,10–12]. I have recently reviewed the compelling rationale for both an increased emphasis on darkness and rejection of the diameter criterion in the clinical diagnosis of melanoma [13]. The Georgia approach to melanoma diagnosis uniquely incorporates many elements of these strategies in a complementary manner to increase the sensitivity of diagnosis of early melanoma [13,14] (Figure 1).

Bottom Line: Current clinical approaches to melanoma diagnosis have not been associated with a decrease in mortality from this cancer.The components of the new approach presented are, first, a screening examination to look for any lesion that stands out because of being dark, different, or changing; second, when a single lesion is recognized to be of concern for any reason, that lesion is then evaluated in more detail utilizing the ABCDE criteria, with the "D" signifying "Dark" and not "6 mm Diameter" in this mnemonic; and, third, additional discussion of the "ugly duckling" sign and of the recognition of nodular melanomas.Since the Georgia Society of Dermatology and Dermatologic Surgery was the first state or national society to endorse this approach, I refer to it as the Georgia approach.

View Article: PubMed Central - PubMed

Affiliation: Dermatology, Emory University School of Medicine.

ABSTRACT
Current clinical approaches to melanoma diagnosis have not been associated with a decrease in mortality from this cancer. The components of the new approach presented are, first, a screening examination to look for any lesion that stands out because of being dark, different, or changing; second, when a single lesion is recognized to be of concern for any reason, that lesion is then evaluated in more detail utilizing the ABCDE criteria, with the "D" signifying "Dark" and not "6 mm Diameter" in this mnemonic; and, third, additional discussion of the "ugly duckling" sign and of the recognition of nodular melanomas. Since the Georgia Society of Dermatology and Dermatologic Surgery was the first state or national society to endorse this approach, I refer to it as the Georgia approach.

No MeSH data available.


Related in: MedlinePlus