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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.
Introduction
Becker and Obermayer
Ormsby and Montgomery
Lever
Sulzberger and Wolf
Pillsbury, Shelley, and Kligman
Fitzpatrick and Clark
Lewis and Wheeler
Wayte
Domonkos
Sanderson
Borrie
Clark
Sneddon
Meara
Fry
Sauer
Callen, Stawiski, and Voorhees
Roenigk
Ackerman
McGovern
Roses, Harris, and Ackerman
Dobson and Abele
Ackerman
Ackerman
Friedman, Rigel, and Kopf
Fitzpatrick, Rhodes, Sober, and Mihm
Koh and Rogers
McCarthy et al.
Habif
MacKie
Marks
Mooi WJ and Krausy
Fitzpatrick, Milton, Balch, Shaw, McCarthy, and Sober
National Institutes of Health Consensus Conference
Levine
Holzle, Kind, Plewig, and Burgdorf
Moynihan
Epstein
Marghoob, Slade, Kopf, Rigel, and Friedman
Arndt, Wintroub, Robinson, and LeBoit
Elder and Elenitsas
Barnhill
Maize et al.
Langley, Fitzpatrick, and Sober
Sagebiel
Farmer and Hood
Fleischer, Feldman, Katz, and Clayton
Ackerman, Kerl, Sánchez, et al.
References
SEE ALSO
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melanoma
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Callen, Stawiski, and Voorhees
"The key to recognition of melanoma is color . . . Irregular pigmentation with shades of blue-black, red, white and brown occurs. The skin markings are often disturbed, and the border is irregular. Satellite lesions, nodule, ulceration, bleeding, recent changes in size or color and diffusion of pigment into normal skin are other signs of melanoma."
Callen JP, Stawiski MA, Voorhees JJ.
Manual of Dermatology.
Chicago: Year Book Medical Publishers, Inc., 1980:97.
Brief critique
The notion that common colors of melanoma are "blue-black, red, white, and brown" is fallacious. Macules of melanoma usually are characterized by nuances of brown. Even more elevated lesions of melanoma generally are devoid of blue, black, red, and white. In short, color often is not the key to recognition of melanoma; the key is a constellation of morphologic findings, only one of which is color. The word "irregular" for pigmentation and for the border of a lesion is confusing because no lucid definition of "regular" has ever been set forth. By the time that satellite lesions, nodularity, ulceration, and bleeding have occurred, the melanoma almost always has metastasized.
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