More ways to spot dangerous spots

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Some melanomas might not have common tell-tale signs, so we should be paying attention to extra clues, according to Australian researchers. The authors say thick, life-threatening melanomas may lack the more classical ABCD (asymmetry, border irregularity, colour variegation, diameter of more than 6mm) features. They recommend adding EFG (elevated, firm and growing) to help spot the more unusual melanomas. Any spot that is changing shape or growing for more than one month should be removed or referred for expert opinion, they add.

Journal/conference: The Medical Journal of Australia

Organisation/s: Monash University, Melanoma Institute Australia, The University of Sydney, Victorian Melanoma Service

Media Release

From: Medical Journal of Australia (MJA)

A guide to identifying atypical melanomas

Early diagnosis remains critical to reducing the risk of death from cutaneous melanomas, and new guidelines from Cancer Council Australia are designed to help health practitioners identify atypical presentations, according to a summary published in the Medical Journal of Australia.

A Cancer Council working group is revising and updating the 2008 evidence-based clinical practice guidelines for the management of cutaneous melanoma, and a chapter dedicated to atypical presentations has been summarised by Dr Victoria Mar, Consultant Dermatologist, and co-authors from the Victorian Melanoma Service at the Alfred Hospital, Monash University Department of Public Health and Preventive Medicine., Peter MacCallum Cancer Centre, the Melanoma Institute Australia and the University of Sydney.

“Because thick, life-threatening melanomas may lack the more classical ABCD (asymmetry, border irregularity, colour variegation, diameter > 6mm) features of melanoma, a thorough history of the lesion with regard to change in morphology and growth over time is essential,” the authors wrote.

“Any lesion that is changing in morphology or growing over a period of more than one month should be excised or referred for prompt expert opinion.”

Adding EFG (elevated, firm and growing) to the ABCD criteria would help identify atypical melanomas. “Any lesion that is elevated, firm and growing over a period of more than one month should raise suspicion for melanoma.”

“Melanomas are generally distinguished from benign lesions by their history of change... Therefore, careful history taking is important, and any lesion that continues to grow or change in size, shape, colour or elevation over a period of more than one month should have a biopsy taken and be assessed histologically or referred for expert opinion,” the authors recommended.

“Suspicious raised lesions should be excised rather than monitored.”

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The Medical Journal of Australia is a publication of the Australian Medical Association.

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