期刊
BRITISH JOURNAL OF DERMATOLOGY
卷 151, 期 5, 页码 1081-1083出版社
BLACKWELL PUBLISHING LTD
DOI: 10.1111/j.1365-2133.2004.06248.x
关键词
melanoma; prognosis
类别
Background Melanoma prognosis is dependent upon early recognition and treatment. There is a need for good clinical guidelines that focus on the early signs of melanoma. The ABCD (asymmetry, border, colour and diameter) rule states that most melanomas are more than 6 mm in diameter. Critics crave a modification, arguing that small diameter melanomas are not infrequent. Objectives The aim of the present study was to describe the frequency and prognosis of melanomas less than 7 mm in a clinical setting. Methods The Norwegian Melanoma Project was conducted as a multicentre, prospective study with inclusion criteria. Patients were recruited from five dermatological departments in Norway from 1990 to 1993. Results The frequency of small melanomas was 11.4% (18/158). One-third was in situ melanoma, the rest invasive with a median thickness of 0.8 mm. Four small melanomas were T2 lesions, with a Breslow thickness of more than 1 mm. One nodular T2 melanoma recurred locally 2 years after diagnosis and the patient died of distant metastasis only months later. Conclusions The ABCD rule remains a practical guide for early recognition of melanoma. Clinicians must be aware of its limitations.
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