McGovern

 
"The majority of melanomas do not present any difficulty in diagnosis, either clinically or histologically. Patients usually seek attention when a mole or "birth mark" is enlarging or bleeding. In order of frequency, the first symptoms noticed by patients are an increase in size, a color change, bleeding, and itching."
 
McGovern VJ. Melanoma: Histological Diagnosis and Prognosis. New York: Raven Press, 1983:100.
 

Brief critique

 
By the time that patients note bleeding of a "mole" or "birthmark," the melanoma probably has metastasized. The emphasis of McGovern is on "symptoms noticed by patients," rather than on morphologic signs identifiable by clinicians. In brief, as recently as 1983, what authors stressed for diagnosis of melanoma are signs and symptoms that patients call to the attention of physicians, rather than on morphologic findings physicians can recognize in lesions that are small and flat, and, therefore, curable.