The “Funny looking” mole, like the “ugly duckling sign,” implies that there is an overall gestalt one can have about a spot being suspicious.
Therefore, we propose a modification to the ABCDE rule in order to combine the benefits of this rule with that of the “ugly duckling sign.” The addition of the letter “F,” which stands for “Funny looking,” nicely incorporates the “ugly duckling rule” into one, unified tool-the ABCDEF rule-for patients to use when evaluating their moles at home. That is, the ABCDE rule does not account for the added screening benefits of using the “ugly duckling rule,” and vice versa. However, the shortcoming of using only one of these criteria is that the ABCDE and “ugly duckling” rules are complementary to one another and are not necessarily equal alternatives to one another. Their limitations aside, both of these methods provide an easy, general framework from which patients may work in order to identify potential melanomas.ĭue to time constraints or personal preference, dermatologists often choose to counsel patients on one of these guidelines while neglecting the other. 5 It states that the “spot” that is unlike the others is often the most suspect for malignancy. An alternative to the ABCDE rule, the “ugly duckling sign,” was later developed to address the limitations of the ABCDE rule. The ABCDE rule, first introduced in 1985 as the ABCD rule 3 and then expanded in 2004 to the ABCDE rule, 4 encompasses several clinical features of melanoma, including Asymmetry, Border irregularity, Color variation (both intralesional color variation as well as a color that is different from the patient’s other nevi), Diameter greater than 6mm, and Evolving (a new or changing lesion). To aid patients in identifying possible melanoma, we often recommend the use of either the “ABCDE rule” or the “ugly duckling sign.” 2 At our institution, we counsel patients to perform regular self-skin examinations in an effort to expedite identification and appropriate treatment of suspicious melanocytic lesions.
ABCD CANCER SKIN
1 Accordingly, the American Academy of Dermatology has sought to improve patient awareness of melanoma through its SPOT Skin Cancer campaign. Regular self-skin examinations by patients have been shown to decrease the depth of melanomas at the time of diagnosis and facilitate a lower risk of melanoma when coupled with regular visits with a physician.
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