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Using the Alphabet to Identify Malignant Melanoma

Part of the Physician Assistant Exam For Dummies Cheat Sheet

You can use the alphabetic classification system to evaluate melanoma, the most aggressive form of skin cancer. This guide helps you determine whether a skin lesion is malignant. The mnemonic is the first five letters of the English alphabet — A, B, C, D, and E. Here are the warning signs:

  • A = asymmetry: If one side of the lesion differs from the other, the lesion is more likely to be malignant.

  • B = borders: Are the borders of the skin lesion regular or irregular? Are they smooth or spiculated? The more irregular the borders, the greater the likelihood that you’re dealing with a malignancy.

  • C = colors: The melanoma may have more than one color.

  • D = diameter: The larger the lesion, the greater the risk that it’s melanoma. A skin lesion of more than 9–10 mm is more suspicious for melanoma.

  • E = evolution: How is the lesion changing over time, in terms of appearance and size? Melanoma is more likely to change.

If you suspect melanoma, the next step is a skin biopsy.

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