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As pointed out by Rigel et al,¹ the ABCD (asymmetry, border irregularity, color variegation, and diameter >6 mm) criteria have been useful in promoting early detection of melanoma to the general public over the past 20 years.² We now need to take the next step, but adding letters is not the best approach.³

The most important warning sign for early detection of melanoma is change, ie, change in size, shape, or color of an existing lesion or the appearance of a new growth.^4-5 Secondary and appropriately qualified messages may include the ABCD signs, the "ugly duckling" sign, and sores that do not heal, as well as caveats regarding normal changes in skin lesions, particularly in childhood and early adulthood.⁶ However, any primary message with ABCD at its core (such as the ABCDE acronym suggested by Rigel et al¹) may be misleading, because nodular melanomas, which are particularly important causes . . . [Full Text of this Article]

AUTHOR INFORMATION
Martin A. Weinstock, MD, PhD

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