NYU Notes 25th Anniversary of ABCDE Melanoma Diagnosis Tool


2010 marks the 25th year anniversary of the development of the ABCDEs acronym developed by dermatologists at NYU Langone Medical Center that provide criteria for diagnosing melanoma.

One American dies every hour from melanoma, the deadliest of the major forms of skin cancer. If detected early, melanoma can be successfully treated.

“NYU Langone Medical Center is proud to have created a system which successfully diagnoses melanoma and save lives,” said Seth J. Orlow MD, PhD, chairman, The Ronald O. Perelman Department of Dermatology and director on Center of Excellence in Cancers of the Skin at NYU Langone Medical Center. “The impact of the ABCDEs has been profound, creating a simple and quick guide for anyone to examine themselves. Few would argue that countless lives have been saved by of the development and awareness of the ABCDEs—helping detect the most dangerous form of skin cancer while still curable with simple removal before the cancer has spread.”

The ABCDEs for melanoma detection are:

  • A is for Asymmetry, where one half of the mole is unlike the other.
  • B is for Border, where the mole is irregular, scalloped or poorly defined.
  • C is for Color, which varies from one area to another or has different shades of tan, brown, black and sometimes white, red or blue.
  • D is for Diameter of a mole, when it is bigger than the size of a pencil eraser.
  • E is for Evolving, or changing in size, shape or color.

In 1985, Alfred Kopf, MD, then a professor of dermatology and now professor emeritus, along with former NYU fellows Robert Friedman, MD, and Darrell Rigel, MD, both current NYU faculty created the original ABCDs guide: "Early Detection of Malignant Melanoma: The Role of Physician Examination and Self-Examination of the Skin" which was published in the CA: A Cancer Journal for Clinicians.

Nearly 20 years later, David Polsky MD, PhD, associate professor of dermatology, director of the NYU Pigmented Lesion Clinic, along with Kopf, Friedman, Rigel and others, added the “E” to the ABCDs, which was later published in an article titled “Early Diagnosis of Cutaneous Melanoma: Revisiting the ABCD Criteria” published in the Journal of the American Medical Association, updating the acronym to ABCDEs.

“The original ABCD rule was very helpful in identifying early melanoma; however melanoma changes frequently, so we wanted the message to be expanded to ABCDEs rule so that the public would know that any lesion that significantly changes or is “evolving” is a concerning lesion,” said Polsky. “This includes new lesions that appear in patients 50 years of age and older.”

According to experts, minimizing your risk for skin cancer and melanoma is critical. “Performing regular skin self-examination using the ABCDEs guide to check for warning signs of skin cancer, especially melanoma, is an important and easy way to detect suspicious moles that could be cancerous.” says Jennifer Stein, MD, PhD, associate director of the Pigmented Lesion Section at NYU Langone Medical Center.

About NYU Langone Medical Center

NYU Langone Medical Center is one of the nation's premier centers of excellence in health care, biomedical research and medical education. For more than 168 years, NYU physicians and researchers have made countless contributions to the practice and science of health care. Today the Medical Center consists of NYU School of Medicine, including the Smilow Research Center, the Skirball Institute of Biomolecular Medicine, and the Sackler Institute of Graduate Biomedical Sciences; the three hospitals of NYU Hospitals Center, Tisch Hospital, a 705-bed acute-care general hospital, Rusk Institute of Rehabilitation Medicine, and NYU Hospital for Joint Diseases, a leader in musculoskeletal care; and such major programs as the NYU Cancer Institute, the NYU Child Study Center, and the Hassenfeld Children's Center for Cancer and Blood Disorders.

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