ABCDE Rule

Clinical Assessment of a Lesion

  • He has attached a photograph of the mole:
  • Fleshy warts around armpit

    Figure 5: Fleshy warts around armpit

    • You assess this photograph according to the ABCDE criteria, a very useful system for examining most skin lesions

      Click each of letters of the mnemonic to reveal the assessment:

    A is for Asymmetry

    • These are small and fleshy, and feel like little outgrowings of the normal skin
    • When pressed or flattened out they will feel soft and fleshy and will tend to be round

    B is for Border irregularity

    • Skin tags will feel soft and fleshy to the touch
    • Characteristically they will appear to be separate from the skin attached by a thin stalk
    • It will not be especially easy to assess their border

    C is for Colour variability and/or Changing colour

    • Skin tags usually have the same colour as the underlying skin
    • Occasionally they are pigmented, and can be darker, if for example they have been caught by clothing or jewellery
    • Occasionally they can become infected too

    D is for Different

    • Skin tags can occur as single tags or as crop of similar looking tags

    E is for Evolving (changing)

    • Skin tags can increase in size gradually
    • However, any lesion which appears to be a skin tag but is changing dramatically in appearance and colour needs to be carefully assessed
    ABCDE criteria info from https://dermnetnz.org/topics/abcdes-of-melanoma