HealthDay News — A considerable proportion of children with melanoma do not present with conventional ABCDE melanoma detection criteria, study findings suggest.

Adding additional criteria to assess patients at risk “may facilitate earlier recognition and treatment of melanoma in children,” Kelly M. Cordoro, MD, from the University of California in San Francisco, and colleagues reported in the Journal of the American Academy of Dermatology.

Traditional ABCDE criteria include: asymmetry, border irregularity, color variegation, diameter >6 mm and evolution.

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Cordoro and colleagues conducted a retrospective study involving 60 children with a diagnosis of melanoma and 10 children with ambiguous melanocytic tumors treated as melanoma, who were diagnosed before age 20 years from 1984 to 2009.

The patients were assigned to two groups based on age: group A consisted of participants aged 0 to 10 years (n=19) and group B were those aged 11 to 19 years (n=51).

The researchers found that 60% and 40% of groups A and B, respectively, did not present with conventional ABCDE criteria. The most common features included amelanosis, bleeding, “bumps,” uniform color, variable diameter, and de novo development. They suggested adding these criteria to current screening methods.

Significant between-group variation was observed in histopathological subtypes — 44% were considered histopathologically unclassifiable according to current melanoma subtypes. In groups A and B, 92% and 46% of patients, respectively, had stage IIA disease or higher (P=0.05).

One patient in group A and nine in group B died; 70% of these cases had amelanotic lesions and 60% had one or more major risk factors. Metastasis was predicted with Breslow thickness (adjusted odds ratio, 12.8).


  1. Cordoro KM et al. J Am Acad Dermatol. 2013; 68(6):913-925.