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June 2007

A Confusing Message Will Not Improve the Detection of Melanoma

Arch Dermatol. 2007;143(6):799-816. doi:10.1001/archderm.143.6.806-a

The intent of Liu and her associates1 to define the time available to detect melanoma to improve the treatment of this cancer is admirable. Unfortunately, their recommendations do not advance that aim. They recommend that special attention be given to promote awareness that rapidly growing melanomas are symmetrical, have regular borders, and lack pigment. This message is directly opposite to the one our profession has been teaching the public for the past 2 decades (the ABCD rule—A, asymmetry; B, border irregularity; C, color variegation; D, diameter >5 mm): that the warning signs of melanoma lesions are pigmentation, asymmetrical shape, and irregular borders. Promoting public awareness that lesions of concern can be pigmented or not, symmetric or asymmetric, and have regular or irregular borders sends a confusing message that is difficult to follow.

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