Ana F Duarte1, Bernardo Sousa-Pinto2, Luís F Azevedo3, Ana M Barros4, Susana Puig5, Josep Malvehy5, Eckart Haneke6, Osvaldo Correia7. 1. Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal, CINTESIS - Centre for Health Technology and Services Research, University of Porto, Portugal. 2. CINTESIS - Centre for Health Technology and Services Research, University of Porto, Portugal, MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal, Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal. 3. CINTESIS - Centre for Health Technology and Services Research, University of Porto, Portugal, MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal. 4. Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal. 5. Dermatology Department, Hospital Clinic de Barcelona, Universitat de Barcelona, IDIBAPS, Barcelona, Spain & Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain. 6. Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal, Department of Dermatology, Inselspital, University of Bern, Bern, Switzerland, Dermatology Clinic Dermaticum, Freiburg, Germany, Department of Dermatology, University of Ghent, Ghent, Belgium. 7. Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal, CINTESIS - Centre for Health Technology and Services Research, University of Porto, Portugal, Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal.
Abstract
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.
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.
Entities:
Keywords:
ABCDE rule; early detection; malignant melanoma (MM); non-dermatologist