Melanoma physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: : Yazan Daaboul, M.D., Serge Korjian M.D., Jesus Rosario Hernandez, M.D. [2].

Overview

Physical examination findings suggestive of malignant melanoma include ABCDE: Asymmetry of the lesion, Border irregularity, Color change, large Diameter, and Evolution over time.

Physical Examination

Skin

Although melanoma can occur anywhere, melanoma among women occurs more commonly on the extremities, and among men it occurs more commonly on the trunk or head and neck.
Patients with suspected melanoma should have a full-body examination for other lesions.

On physical examination, the ABCDE for distinguishing benign nevi from malignant melanoma are:

A – Asymmetry (suggestive of melanoma)^[1]^[2]
B – Border irregularity (suggestive of melanoma)
C – Color (irregular color or discoloration, very dark color suggestive of melanoma)
D – Diameter (large size or increase in size suggestive of melanoma)
E – Evolution over time

Other signs in a nevus that would suggest a malignant change include the following:

Development of satellites
Ulceration or bleeding (late signs)^[3]^[4]^[5]

Any suggestive findings detected on physical exam warrant a complete excisional biopsy. To view the complete approach for a suspected melanoma, click here.

Gallery

HEENT

Extremities

Genitales

url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=283>

References

↑ Lee H, Kwon K (March 2017). “A mathematical analysis of the ABCD criteria for diagnosing malignant melanoma”. Phys Med Biol. 62 (5): 1865–1884. doi:10.1088/1361-6560/aa562f. PMID 28036304.
↑ Tsao H, Olazagasti JM, Cordoro KM, Brewer JD, Taylor SC, Bordeaux JS, Chren MM, Sober AJ, Tegeler C, Bhushan R, Begolka WS (April 2015). “Early detection of melanoma: reviewing the ABCDEs”. J. Am. Acad. Dermatol. 72 (4): 717–23. doi:10.1016/j.jaad.2015.01.025. PMID 25698455.
↑ Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, Nørgaard PH, Steiniche T (December 2014). “Prognostic stratification of ulcerated melanoma: not only the extent matters”. Am. J. Clin. Pathol. 142 (6): 845–56. doi:10.1309/AJCPW56PHGLFTKZC. PMID 25389339.
↑ Callender GG, McMasters KM (2011). “What does ulceration of a melanoma mean for prognosis?”. Adv Surg. 45: 225–36. PMID 21954690.
↑ Tromme I, Sacré L, Hammouch F, Richez P, Degryse JM, Speybroeck N (December 2018). “Melanoma diagnosis: predictive value of macroscopic changes observed by the patient”. Melanoma Res. 28 (6): 611–617. doi:10.1097/CMR.0000000000000496. PMID 30192302.

[pmid28036304-1] Lee H, Kwon K (March 2017). “A mathematical analysis of the ABCD criteria for diagnosing malignant melanoma”. Phys Med Biol. 62 (5): 1865–1884. doi:10.1088/1361-6560/aa562f. PMID 28036304.

[pmid25698455-2] Tsao H, Olazagasti JM, Cordoro KM, Brewer JD, Taylor SC, Bordeaux JS, Chren MM, Sober AJ, Tegeler C, Bhushan R, Begolka WS (April 2015). “Early detection of melanoma: reviewing the ABCDEs”. J. Am. Acad. Dermatol. 72 (4): 717–23. doi:10.1016/j.jaad.2015.01.025. PMID 25698455.

[pmid25389339-3] Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, Nørgaard PH, Steiniche T (December 2014). “Prognostic stratification of ulcerated melanoma: not only the extent matters”. Am. J. Clin. Pathol. 142 (6): 845–56. doi:10.1309/AJCPW56PHGLFTKZC. PMID 25389339.

[pmid21954690-4] Callender GG, McMasters KM (2011). “What does ulceration of a melanoma mean for prognosis?”. Adv Surg. 45: 225–36. PMID 21954690.

[pmid30192302-5] Tromme I, Sacré L, Hammouch F, Richez P, Degryse JM, Speybroeck N (December 2018). “Melanoma diagnosis: predictive value of macroscopic changes observed by the patient”. Melanoma Res. 28 (6): 611–617. doi:10.1097/CMR.0000000000000496. PMID 30192302.

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