AI Article Synopsis
- Melanoma prognosis relies heavily on early detection and treatment, highlighting the need for effective clinical guidelines to identify early signs.
- Critics of the ABCD rule point out that small melanomas (less than 6 mm) are common, which has prompted further investigation into their frequency and prognosis.
- In a study involving patients from Norway, small melanomas accounted for 11.4% of cases, with diverse outcomes, emphasizing the importance of recognizing the limitations of the ABCD rule in melanoma diagnosis.
Article Abstract
Background: Melanoma prognosis is dependent upon early recognition and treatment. There is a need for good clinical guidelines that focus on the early signs of melanoma. The ABCD (asymmetry, border, colour and diameter) rule states that most melanomas are more than 6 mm in diameter. Critics crave a modification, arguing that small diameter melanomas are not infrequent.
Objectives: The aim of the present study was to describe the frequency and prognosis of melanomas less than 7 mm in a clinical setting.
Methods: The Norwegian Melanoma Project was conducted as a multicentre, prospective study with inclusion criteria. Patients were recruited from five dermatological departments in Norway from 1990 to 1993.
Results: The frequency of small melanomas was 11.4% (18/158). One-third was in situ melanoma, the rest invasive with a median thickness of 0.8 mm. Four small melanomas were T2 lesions, with a Breslow thickness of more than 1 mm. One nodular T2 melanoma recurred locally 2 years after diagnosis and the patient died of distant metastasis only months later.
Conclusions: The ABCD rule remains a practical guide for early recognition of melanoma. Clinicians must be aware of its limitations.
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| http://dx.doi.org/10.1111/j.1365-2133.2004.06248.x | DOI Listing |
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