Comparison of elements in clinical prediction rules for malignant melanoma
(a) Clinical rules | ||||
---|---|---|---|---|
Clinical CPR name | ||||
Elements | ABCD | ABCDE | 7-point checklist | Revised 7-point checklist |
Asymmetry | X | X | X | |
Border irregularity | X | X | X | |
Colour variegation | X | X | X | X |
Diameter (>6 mm) | X | X | X (>7 mm) | X (>7 mm) |
Evolving (eg, size, shape, colour) | X | X (size) | X | |
Altered sensation | X | X | ||
Inflammation | X | X | ||
Crusting, bleeding | X | X | ||
Cut-point | ≥1 | ≥1 or ≥2 | ≥3 | ≥3 |
(b) Dermoscopic rules | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CPR name | ||||||||||||||||
Element | ABCD | 7-point checklist | Revised 7-point checklist | Menzies 1996 | 3-point checklist | 7FFM | CASH | ABCDE | 3-colour test | Kreusch 1992 | Nilles 1994 | Menzies 2008—melanoma | Menzies 2008—skin cancer | DynaMel | Simplified ABC | AC rule |
Asymmetry | X | X | X | X | X | X | X | X | X | X | X | X | ||||
Multiple colours (light/dark brown, black, red, white, blue) | X | X | X | X | X | X | X | X | X | X | X | X | X | |||
Architectural disorder (structures and colours) | X | X | X | X | X | X | X | X | ||||||||
Atypical network | X | X | X | X | X | X | X | X | X | |||||||
Blue-white veil | X | X | X | X | X | X | ||||||||||
Blue-white structures | X | X | ||||||||||||||
Streaks/radial streaming/pseudopods | X | X | X | X | X | X | X | X | X | X | ||||||
Dots, globules | X | X | X | X | X | X | X | X | X | |||||||
Regression structures or erythema | X | X | X | X | X | X | X | X | ||||||||
Scarring | X | X | ||||||||||||||
Blotches (structure less region >10% | X | X | X | |||||||||||||
Atypical vascular pattern | X | X | X | X | X | X | X | |||||||||
Recognisable as benign | X | |||||||||||||||
Abrupt cut-off border pigment | X | X | X | X | ||||||||||||
Blue-grey dots | X | |||||||||||||||
Change | X | X | X | X | ||||||||||||
Cut-point | ≥4.75 ≥5.45 | ≥3 | ≥1 | ≥1, no features | ≥1 | ≥2 | ≥2 | Not reported | ≥3 | Not reported | Not reported | ≥1 | ≥0 (high sensitivity) ≥1 (high specificity) | ≥3 | ≥4 | Not reported |
ABC, Asymmetry, irregular Borders, more than one or uneven distribution of Colour; ABCD, Asymmetry, irregular Borders, more than one or uneven distribution of Colour, or a large (greater than 6 mm) Diameter; ABCDE, Asymmetry, irregular Borders, more than one or uneven distribution of Colour, or a large (greater than 6mm)Diameter, Evolution of moles; AC, asymmetry, colour variation; CASH, color, architecture, symmetry, and homogeneity; CPR, clinical prediction rules; FFM, features for melanoma.