Small diameter melanoma: a follow-up of the Norwegian Melanoma Project
- 1 November 2004
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Dermatology
- Vol. 151 (5), 1081-1083
- https://doi.org/10.1111/j.1365-2133.2004.06248.x
Abstract
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.The aim of the present study was to describe the frequency and prognosis of melanomas less than 7 mm in a clinical setting.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.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.The ABCD rule remains a practical guide for early recognition of melanoma. Clinicians must be aware of its limitations.Keywords
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