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Add an 'E' to the alphabet for identifying melanoma

One more letter should be added to the alphabetic list of warning signs of melanoma, a potentially deadly skin cancer, according to a group of NYU School of Medicine dermatologists and their Australian colleagues. Based on a review of the medical literature, they recommend adding the letter "E" -- for "evolving" -- to the first four letters of the alphabet that are already used widely to help physicians and adults identify suspicious moles on the skin.

Their report is published in the Dec. 8, 2004, issue of the Journal of the American Medical Association (JAMA).

Almost 20 years ago, a group of NYU dermatologists introduced the ABCD acronym for recognizing growths on the skin that could be early melanomas. They devised the rule based on many years of clinical experience, which taught them that early melanomas can be identified by their asymmetry, uneven borders, colors, and size.

The warning signs are: "A" for asymmetry; one half of a mole doesn't match the other half; "B" for border irregularity; the edges of a mole are ragged, notched or blurred; "C" for color; a non-uniform mixture of brown, black, red, white, or blue; and "D" for diameter greater than 6 millimeters, the size of a pencil eraser.

The ABCD rule has been helpful in identifying early melanoma. But now the original group of NYU dermatologists who devised the rule, along with some of their younger colleagues, recommends expanding the rule to recognize that early melanomas frequently change in appearance. This is especially true for a type of melanoma called nodular that doesn't fit neatly into the ABCD criteria, explains David Polsky, M.D., Ph.D., a dermatologist and one of the authors of the new report. Dr. Polsky is Associate Director of the NYU Department of Dermatology's Pigmented Lesions Section.

Nodular melanoma accounts for 10 to 15 percent of all melanomas. One of four basic types of melanomas, the nodular for
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Contact: Jennifer Berman
Jennifer.Berman@med.nyu.edu
212-404-3555
New York University Medical Center and School of Medicine
7-Dec-2004


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