In the ABCDE rule for pigmented skin lesions, which feature is most worrisome for melanoma?

In the ABCDE rule for pigmented skin lesions, which feature is most worrisome for melanoma?

• A. Evolution (change over time).
• B. Asymmetry.
• C. Border irregularity.
• D. Diameter >6 mm.

Answer: (A)

Evolution, or change over time, is the strongest warning sign because melanoma tends to progress. A lesion that grows, changes shape or color, or develops new symptoms like itching or bleeding signals that it may be mutating, which sets it apart from most benign moles that remain stable. While other features like asymmetry, border irregularity, or a diameter over 6 mm are concerning, they can appear in benign lesions too, and size alone isn’t as reliable—melanomas can be small at first. The key idea is to watch for any evolution and seek evaluation promptly if a mole changes.