The ABCDE rule highlights warning signs for malignant melanoma (MM). A study evaluated whether the ABCDE signs are associated with the early detection of MM, utilizing the retrospective study over 11.5 years. 

144 MM were included in the study with 36.1% in situ and 63.9% invasive lesions. In 23.6% of the cases, the MM was first doubted by a non-dermatologist. The “E sign” was found to be less frequent among in situ lesions (32.7% vs 50.0%). The possibility of MM being first suspected by a non-dermatologist unfailingly increased with the number of ABCDE signs of the lesion (varying from 8% for a neoplasm with no ABCDE signs to 32% for a lesion with all 5 signs).

Thus, the greater the number of ABCDE signs, the greater are the chances of MM being first suspected by a non-dermatologist, except in situ MM diagnosis. Depending on the ABCDE rule alone may miss early MM lesions. 

SOURCE- Duarte AF, Sousa-Pinto B, Azevedo LF, Barros AM, Puig S, Malvehy J, Haneke E, Correia O. Clinical ABCDE rule for early melanoma detection. Eur J Dermatol 2021; 31(6): 771-8 doi:10.1684/ejd.2021.4171