Clinical ABCDE rule for early melanoma detection

BACKGROUND: The ABCDE rule systematizes warning signs for malignant melanoma (MM). OBJECTIVES: To evaluate whether the ABCDE signs are associated with early detection of MM. MATERIALS & METHODS: Based on a retrospective study over 11.5 years, we assessed whether ABCDE signs are associated with early diagnosis of MM. RESULTS: In total, 144 MM were included; 52 (36.1%) in situ and 92 (63.9%) invasive lesions. For 23.6%, the MM were first suspected by an individual other than a dermatologist. The "E sign" was significantly less frequent among in situ lesions (32.7% versus 50.0%; p = 0.044). Based on adjusted analyses, the probability of MM being first suspected by a non-dermatologist consistently increased with the number of ABCDE signs of the lesion, ranging from 8% for a neoplasm with no ABCDE signs to 32% for a lesion with five signs (OR = 1.6; 95% CI: 1.2-2.2; p = 0.004). CONCLUSION: A higher number of ABCDE signs were associated with a greater chance of MM being first suspected by a non-dermatologist, but not in situ MM diagnosis. Relying on the ABCDE rule alone might result in missing early MM lesions.