Melanoma physical examination

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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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Overview

Physical exam findings suggestive of malignant melanoma include ABCD: Asymmetry of lesion, irregular Borders, Color change, and increased Depth.

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 ABCDs for distinguishing benign nevi from malignant melanoma are:
  • A - Asymmetry (suggestive of melanoma)
  • B - Border irregularity (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)
  • Other signs in a nevus that would suggest a malignant change include the following:
  • Development of satellites
  • Ulceration or bleeding (late signs)
  • Any suggestive findings detected on physical exam warrant a complete excisional biopsy. To view the complete approach for a suspected melanoma, click here.

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