What is the ABCDE rule for?

Almost every person has a more or less large number of moles or liver spots - medically called Nävi. These benign pigmentation spots, however, can rarely develop into a malignant carcinoma called malignant melanoma. In order to have the highest possible chance of recovery, such a "black skin cancer" must be removed and treated as soon as possible.

It is therefore very important to discover the transition from the harmless pigment spot to the potential melanoma as early as possible.


Irregular, colorful patches of pigmentation are suspicious

The classic picture of a malignant melanoma is that of a clearly recognizable, very dark, sometimes also inflamed, skin tumor, which is usually very irregular. But it is not easy at the beginning stages to judge a nevus as suspicious. Doctors frequently use the so-called ABCDE scheme for a first gaze diagnosis, by means of which it can be roughly determined whether a pigment spot appears harmless or rather suspect.

This ABCDE rule assesses the properties of the stain. This is

  • A for asymmetry, (Noticeable are irregular spots, clear round or oval spots are considered unsuspicious).
  • B for limitation, (Jagged edges, tongue-shaped foothills and blurred borders are rather suspect here).
  • C for color / english: color, (Irregular discoloration and various shades should be investigated more closely).
  • D for the diameter, (If pigmentation changes its original size or a suspicious spot is over 5mm in size, it may be worth investigating).
  • E for grandeur, (If a suspicious pigment spot exceeds the skin surface, it may also be a sign of malignancy).

If you notice a change in pigment itself, you should always consult a dermatologist if you have any doubts. Regular check-ups at the dermatologist are especially recommended for fair-skinned people with many liver spots. Important: The assessment of suspected skin pigmentation is always in the hands of professionals! It can be a fatal mistake to use the ABCDE rule as a layperson to rule out a suspicion, and to use it as an example. saves the doctor's visit.

Make every suspicion clear

To reassure you: Most pigment changes turn out to be completely harmless. In most cases, several of the abovementioned criteria must first come together to justify a serious suspicion of malignancy. However, since small, early-discovered melanomas are usually very well curable, advanced, however, often have a fatal prognosis, it is worth a medical examination even at the slightest suspicion.

Author: Dr. med. Monika Steiner