Dermatology World

Study suggests revised ABCD criteria for pediatric melanoma

Acta Eruditorum

Abby Van Voorhees

Dr. Van Voorhees is the physician editor of Dermatology World. She interviews the author of a recent study each month.

By Abby S. Van Voorhees, MD, September 2, 2013

In this month’s Acta Eruditorum column, Physician Editor Abby S. Van Voorhees, MD, talks with Kelly M. Cordoro, MD, about her recent Journal of the American Academy of Dermatology article, “Pediatric melanoma: Results of a large cohort study and proposal for modified ABCD detection criteria for children.”

Dr. Van Voorhees: Thankfully, melanomas in children are fairly rare. They are also very challenging for many of us to diagnose. What do you feel makes this diagnosis so difficult for the clinician? Is it just a low index of suspicion? Do they present in an atypical way?

Dr. Cordoro: Melanomas in children can be difficult to diagnose for several reasons, a couple of which you alluded to, such as a low index of suspicion for skin cancer in children as well as pediatric melanoma’s propensity to present atypically. Age plays a considerable role on all accounts the younger a child is, the less suspicious we tend to be. Low index of suspicion together with presenting features distinct from those we see in adult melanomas combine forces to make diagnosis challenging. Pre-pubertal children in particular frequently present with melanomas that do not fall in line with conventional clinical features as described by the acronym ABCD —  Asymmetry, Border irregularity, Color variegation, and Diameter. Adding to the confusion is the resemblance of amelanotic melanomas, a common clinical subtype in young children, to benign lesions such as pyogenic granulomas and warts.