When you assess your patients for signs of malignant melanoma, consider how much they are in HARMM’s way.

That’s the mnemonic acronym devised by dermatologists who analyzed data from 365,000 individual skin exams done from 2001 through 2005. The researchers found five factors that independently increase the likelihood of suspicious lesions. They are: History of melanoma; Age over 50; Regular dermatologist absent; Mole changing; and Male gender.

Risks rose according to how many factors patients exhibited. “Individuals at highest risk for melanoma—who had four or five of the factors—comprised only 5.8% of the total study population, yet they accounted for 13.6% of the probable melanoma findings,” the researchers reported. “Interestingly, these people also were 4.4 times more likely to be diagnosed with suspected melanomas than individuals at lower risk, with zero or only one risk factor.”

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“Total skin examination should be strongly encouraged for those individuals who have multiple melanoma risk,” the researchers concluded (J Am Acad Dermatol. 2007; published online).