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June K. Robinson, MD; Rob Turrisi, PhD

Arch Dermatol. 2006;142:447-452.

Objective  To develop skin self-examination skills by improving the use of the ABCDE criteria by those at risk of developing melanoma.

Design  Ten single-sex groups of 10 unrelated adults received a knowledge-based intervention followed by skills training.

Setting  Classroom in the ambulatory care area of a hospital.

Patients  One hundred unrelated adults with either a personal or family history of melanoma and no previous skin self-examination counseling.

Interventions  A dermatologist presented information, and each subject read a brochure and reviewed a bookmark. The facilitator led the group discussions about scoring each feature and the decision to seek medical care. Measurement of moles with a ruler and a pencil eraser and the use of an illuminated magnifying lens were demonstrated. Preintervention and postintervention assessments were performed for each intervention.

Main Outcome Measure  Recognition of A, B, C, D, and E traits.

Results  The subjects preferred the bookmark (87% of subjects), opaque ruler (94% of subjects), and lighted magnifying lens (81% of subjects) to reading the brochure, which was felt to take too long. Recognition of border irregularity, color variation, and diameter improved significantly after the intervention. Women recognized color variation more often than men (94% vs 62%; odds ratio [OR], 23.7; 95% confidence interval [CI], 16.1-50.5). Men identified irregular borders more often than women (91% vs 75%; OR, 16.8; 95% CI, 4.5-22.6). Women appropriately decided to see a physician more often than men (81% vs 57%; OR, 13.5; 95% CI, 7.1-28.4).

Conclusions  Determining the presence of the A, B, C, and E criteria is challenging for the novice. Skills training aided performance of skin self-examination. Differences in proclivities according to sex suggest that if men and women form partnerships for skin checks, they may learn from each other, and their combined strengths will promote detection of early melanomas.

Author Affiliations: Northwestern University Feinberg School of Medicine, Chicago, Ill (Dr Robinson); and Biobehavioral Health and Prevention Research Center, The Pennsylvania State University, University Park (Dr Turrisi).

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