Melanoma physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}}; {{AE}}: {{YD}}, {{SSK}}, {{JH}}. | {{CMG}}; {{AE}}: {{YD}}, {{SSK}}, {{JH}}. | ||
{{Melanoma}} | {{Melanoma}} | ||
==Overview== | ==Overview== | ||
Physical examination findings suggestive of malignant melanoma include | Physical examination findings suggestive of [[malignant]] melanoma include ABCDE: <u>A</u>symmetry of the [[lesion]], <u>B</u>order irregularity, <u>C</u>olor change, large [[Diameter|<u>D</u>iameter]], and <u>E</u>volution over time. | ||
==Physical Examination== | ==Physical Examination== | ||
===Skin=== | ===Skin=== | ||
*Although melanoma can occur anywhere, melanoma among women occurs more commonly on the extremities, and among men it occurs more commonly on the trunk or head and neck. | *Although melanoma can occur anywhere, melanoma among women occurs more commonly on the [[Limb (anatomy)|extremities]], and among men it occurs more commonly on the [[trunk]] or [[head]] and [[neck]]. | ||
*Patients with suspected melanoma should have a full-body examination for other lesions. | *[[Patient|Patients]] with suspected melanoma should have a full-[[Human body|body]] examination for other [[Lesion|lesions]]. | ||
*On physical examination, the | *On [[physical examination]], the ABCDE for distinguishing [[benign]] [[Nevus|nevi]] from [[malignant]] melanoma are: | ||
:*'''A''' - ''Asymmetry'' (suggestive of melanoma) | :*'''A''' - ''Asymmetry'' (suggestive of melanoma)<ref name="pmid28036304">{{cite journal |vauthors=Lee H, Kwon K |title=A mathematical analysis of the ABCD criteria for diagnosing malignant melanoma |journal=Phys Med Biol |volume=62 |issue=5 |pages=1865–1884 |date=March 2017 |pmid=28036304 |doi=10.1088/1361-6560/aa562f |url=}}</ref><ref name="pmid25698455">{{cite journal |vauthors=Tsao H, Olazagasti JM, Cordoro KM, Brewer JD, Taylor SC, Bordeaux JS, Chren MM, Sober AJ, Tegeler C, Bhushan R, Begolka WS |title=Early detection of melanoma: reviewing the ABCDEs |journal=J. Am. Acad. Dermatol. |volume=72 |issue=4 |pages=717–23 |date=April 2015 |pmid=25698455 |doi=10.1016/j.jaad.2015.01.025 |url=}}</ref> | ||
:*'''B''' - ''Border irregularity'' (suggestive of melanoma) | :*'''B''' - ''Border irregularity'' (suggestive of melanoma) | ||
:*'''C''' - ''Color'' (irregular color or discoloration, very dark color suggestive of melanoma) | :*'''C''' - ''Color'' (irregular color or discoloration, very dark color suggestive of melanoma) | ||
:*'''D''' - ''Diameter'' (large size or increase in size suggestive of melanoma) | :*'''D''' - ''[[Diameter]]'' (large size or increase in size suggestive of melanoma) | ||
:*'''E''' - ''Evolution over time'' | |||
*Other signs in a nevus that would suggest a [[malignant]] change include the following: | *Other signs in a nevus that would suggest a [[malignant]] change include the following: | ||
:*Development of satellites | :*Development of [[Satellite (biology)|satellites]] | ||
:*Ulceration or [[bleeding]] (late signs) | :*[[Ulcer|Ulceration]] or [[bleeding]] (late signs)<ref name="pmid25389339">{{cite journal |vauthors=Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, Nørgaard PH, Steiniche T |title=Prognostic stratification of ulcerated melanoma: not only the extent matters |journal=Am. J. Clin. Pathol. |volume=142 |issue=6 |pages=845–56 |date=December 2014 |pmid=25389339 |doi=10.1309/AJCPW56PHGLFTKZC |url=}}</ref><ref name="pmid21954690">{{cite journal |vauthors=Callender GG, McMasters KM |title=What does ulceration of a melanoma mean for prognosis? |journal=Adv Surg |volume=45 |issue= |pages=225–36 |date=2011 |pmid=21954690 |doi= |url=}}</ref><ref name="pmid30192302">{{cite journal |vauthors=Tromme I, Sacré L, Hammouch F, Richez P, Degryse JM, Speybroeck N |title=Melanoma diagnosis: predictive value of macroscopic changes observed by the patient |journal=Melanoma Res. |volume=28 |issue=6 |pages=611–617 |date=December 2018 |pmid=30192302 |doi=10.1097/CMR.0000000000000496 |url=}}</ref> | ||
* Any suggestive findings detected on physical exam warrant a complete | * Any suggestive findings detected on [[Physical examination|physical exam]] warrant a complete [[Biopsy|excisional biopsy]]. To view the complete approach for a suspected melanoma, click [[Melanoma biopsy#Approach to Patients with Suspected Melanoma|'''here''']]. | ||
===Gallery=== | ===Gallery=== | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Dermatology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 20:30, 3 January 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: : Yazan Daaboul, M.D., Serge Korjian M.D., Jesus Rosario Hernandez, M.D. [2].
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Risk calculators and risk factors for Melanoma physical examination |
Overview
Physical examination findings suggestive of malignant melanoma include ABCDE: Asymmetry of the lesion, Border irregularity, Color change, large Diameter, and Evolution over time.
Physical Examination
Skin
- Although melanoma can occur anywhere, melanoma among women occurs more commonly on the extremities, and among men it occurs more commonly on the trunk or head and neck.
- Patients with suspected melanoma should have a full-body examination for other lesions.
- On physical examination, the ABCDE for distinguishing benign nevi from malignant melanoma are:
- Other signs in a nevus that would suggest a malignant change include the following:
- Development of satellites
- Ulceration or bleeding (late signs)[3][4][5]
- Any suggestive findings detected on physical exam warrant a complete excisional biopsy. To view the complete approach for a suspected melanoma, click here.
Gallery
HEENT
Extremities
Genitales
References
- ↑ Lee H, Kwon K (March 2017). "A mathematical analysis of the ABCD criteria for diagnosing malignant melanoma". Phys Med Biol. 62 (5): 1865–1884. doi:10.1088/1361-6560/aa562f. PMID 28036304.
- ↑ Tsao H, Olazagasti JM, Cordoro KM, Brewer JD, Taylor SC, Bordeaux JS, Chren MM, Sober AJ, Tegeler C, Bhushan R, Begolka WS (April 2015). "Early detection of melanoma: reviewing the ABCDEs". J. Am. Acad. Dermatol. 72 (4): 717–23. doi:10.1016/j.jaad.2015.01.025. PMID 25698455.
- ↑ Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, Nørgaard PH, Steiniche T (December 2014). "Prognostic stratification of ulcerated melanoma: not only the extent matters". Am. J. Clin. Pathol. 142 (6): 845–56. doi:10.1309/AJCPW56PHGLFTKZC. PMID 25389339.
- ↑ Callender GG, McMasters KM (2011). "What does ulceration of a melanoma mean for prognosis?". Adv Surg. 45: 225–36. PMID 21954690.
- ↑ Tromme I, Sacré L, Hammouch F, Richez P, Degryse JM, Speybroeck N (December 2018). "Melanoma diagnosis: predictive value of macroscopic changes observed by the patient". Melanoma Res. 28 (6): 611–617. doi:10.1097/CMR.0000000000000496. PMID 30192302.