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.