A patient with a pigmented skin lesion that shows various features should be referred to a dermatologist for evaluation. The excision of a possible melanoma by a primary care provider unfamiliar with the disease usually should be avoided.
Parameters:
(1) change in size
(2) color
(3) shape
(4) maximum diameter in mm
(5) inflammation
(6) oozing
(7) sensation
|
Parameter |
Finding |
Points |
|
change in size |
none (stable) |
0 |
|
|
present |
2 |
|
color |
regular |
0 |
|
|
irregular |
2 |
|
shape |
regular |
0 |
|
|
irregular |
2 |
|
maximum diameter |
<= 7 mm |
0 |
|
|
> 7 mm |
1 |
|
inflammation |
absent |
0 |
|
|
present |
1 |
|
oozing |
absent |
0 |
|
|
present |
1 |
|
change in sensation |
none (stable) |
0 |
|
|
present |
1 |
where:
• The first 3 parameters are major criteria and the last 4 are minor criteria.
• Ulceration would seem to be another major criterion.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the more significant the lesion.
A patient should be referred if:
(1) total score is >= 3 (2 or more major, one major and one minor, three or more minor)
(2) any single feature that is worrisome
Specialty: Hematology Oncology, Surgery, general, Dermatology
