Utility of Lesion Diameter in the Clinical Diagnosis of Cutaneous Melanoma

Utility of Lesion Diameter in the Clinical Diagnosis of Cutaneous Melanoma
Naheed R. Abbasi, MPH, MD; Molly Yancovitz, MD; Dina Gutkowicz-Krusin, PhD; Katherine S. Panageas, DrPH; Martin C. Mihm, MD; Paul Googe, MD; Roy King, MD; Victor Prieto, MD; Iman Osman, MD; Robert J. Friedman, MD; Darrell S. Rigel, MD; Alfred W. Kopf, MD; David Polsky, MD, PhD


Arch Dermatol. 2008;144(4):469-474.

Objective To determine the utility of the current diameter criterion of larger than 6 mm of the ABCDE acronym for the early diagnosis of cutaneous melanoma.

Design Cohort study.

Setting Dermatology hospital-based clinics and community practice offices.

Patients A total of 1323 patients undergoing skin biopsies of 1657 pigmented lesions suggestive of melanoma.

Main Outcome Measure The maximum lesion dimension (diameter) of each skin lesion was calculated before biopsy using a novel computerized skin imaging system.

Results Of 1657 biopsied lesions, 853 (51.5%) were 6 mm or smaller in diameter. Invasive melanomas were diagnosed in 13 of 853 lesions (1.5%) that were 6 mm or smaller in diameter and in 41 of 804 lesions (5.1%) that were larger than 6 mm in diameter. In situ melanomas were diagnosed in 22 of 853 lesions (2.6%) that were 6 mm or smaller in diameter and in 62 of 804 lesions (7.7%) that were larger than 6 mm in diameter.

Conclusion The diameter guideline of larger than 6 mm provides a useful parameter for physicians and should continue to be used in combination with the A, B, C, and E criteria previously established in the selection of atypical lesions for skin biopsy.