Skin Cancer (Melanoma)

Presentation of a patient with Melanoma skin cancer

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Skin Cancer (Melanoma)

Scenario: A 56-year-old male construction worker presents with right shoulder bursitis. Upon skin inspection, the patient had a black mole on his right upper arm.

He reports that it has been there for a few years and has changed shape, size, and color over the past year. Previously it was a flat brownish color and was round. Presently, it presents as a black, raised area, with irregular borders. As a construction worker, the area is regularly exposed to the sun and he reports he does not use sunblock. The patient received physical therapy treatment for his shoulder. Upon discussion with his orthopedists, the patient was referred to a dermatologist.

Question: In screening a skin growth for skin cancer, what is the common mnemonic and what does it stand for?

Potential answers:

  1. PET-MAC
  2. ABCDE
  3. 5 P’s
  4. SOAP

Answer with rationale: 2. ABCDE

A is for asymmetry. The two halves of the mole would be irregular or asymmetrical. 

B is for border irregularity. The border of the growth will be uneven and could have notches or other irregularities in it.

C is for color variegation. Color variegation can mean either changes in color of the mole over time, or a difference in color between the growth in question and similar growths on the person’s body.

D is for diameter. Typically, moles in question will present as 6 mm or larger.

E is for evolving. This means the skin growth is changing in presentation over time.

For more information see Chapter 68 in The Color Atlas of Physical Therapy

Eric Shamus, DPT, PhD

Professor, Chair of Department of Rehabilitation Sciences, Florida Gulf Coast University