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Dermatopathology: Practical & Conceptual July - September 2001
Evolution in Thinking: Criteria for Clinical Diagnosis of Melanoma, 1947–2000: A Critique in Historical Perspective
Mary Aldrene L. Tan, M.D.
A. Bernard Ackerman, M.D.
Becker and Obermayer
Ormsby and Montgomery
Sulzberger and Wolf
Pillsbury, Shelley, and Kligman
Fitzpatrick and Clark
Lewis and Wheeler
Callen, Stawiski, and Voorhees
Roses, Harris, and Ackerman
Dobson and Abele
Friedman, Rigel, and Kopf
Fitzpatrick, Rhodes, Sober, and Mihm
Koh and Rogers
McCarthy et al.
Mooi WJ and Krausy
Fitzpatrick, Milton, Balch, Shaw, McCarthy, and Sober
National Institutes of Health Consensus Conference
Holzle, Kind, Plewig, and Burgdorf
Marghoob, Slade, Kopf, Rigel, and Friedman
Arndt, Wintroub, Robinson, and LeBoit
Elder and Elenitsas
Maize et al.
Langley, Fitzpatrick, and Sober
Farmer and Hood
Fleischer, Feldman, Katz, and Clayton
Ackerman, Kerl, Sánchez, et al.
"The classic malignant melanoma is a black or purple nodule, but it may be flat, or pedunculated, and may be pink, red, tan, brown, or black.
The changes in a recent or longstanding skin lesion that should arouse suspicion include change in the size or shape, change in pigmentation (particularly the development of pseudopodia or areas of satellite pigmentation), erythema surrounding the lesion, induration, friability with easy bleeding tendency, and ulceration."
Manual of Skin Diseases.
4th Edition. Philadelphia: J.B. Lippincott Company, 1980:290.
All of the features mentioned by Sauer, namely, nodularity, pedunculation, satellitosis, bleeding, and ulceration are signs of a melanoma that is likely to prove fatal because it already has metastasized. Features that pertain to changes in a lesion can only be learned by history or through photographs taken serially, not from a single examination morphologically by a physician.
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