[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-533563-105":59,"doc-detail-533563-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","melanoma-most-likely-diagnosis-and-abcde-criteria","Melanoma - Most likely diagnosis and ABCDE criteria","","Case-based medical material describing evaluation of a sun-exposed skin lesion with strong suspicion for nodular malignant melanoma. Compares nodular melanoma growth pattern with superficial spreading melanoma and explains why ABCDE criteria are less sensitive for nodular types. Identifies supportive warning features including the “ugly duckling sign,” elevation, firmness, and continuous growth, and states that diagnosis is confirmed by full-thickness excisional biopsy. Includes brief differential considerations for selected answer choices and a learning objective on proper clinical suspicion.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/melanoma-most-likely-diagnosis-and-abcde-criteria/533563/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/melanoma-most-likely-diagnosis-and-abcde-criteria/533563.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are the ABCDE criteria less sensitive for nodular melanoma?","Question",{"text":112,"@type":113},"Nodular melanoma often grows vertically, so lesions may show fewer classic ABCDE features compared with superficial spreading melanoma. The material notes that ABCDE assists most with superficial spreading, but is less sensitive for other melanoma types like nodular or atypical.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What features should raise suspicion for nodular malignant melanoma?",{"text":117,"@type":113},"Suspicion increases with one or more features such as the “ugly duckling sign,” elevation from surrounding skin, firm palpation, and continuous growth over a month.",{"name":119,"@type":110,"acceptedAnswer":120},"How is melanoma diagnosis generally confirmed?",{"text":121,"@type":113},"The document states that diagnosis is generally confirmed by a full-thickness excisional biopsy.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},533563,1792204213,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Settings  \nA68-year-old man comes to the emergency department due to sudden onset of severe epigastric pain 2 hours ago,accompanied by nausea andan episode of vomiting.The patient has had intermittent abdominal discomfort over the past several months,and an abdominal ultrasoundperformed 2 weeks ago revealed several small gallstones.Other medical conditions include hypertension,type 2 diabetes mellitus,coronaryartery disease,and heart failure with reduced ejection fraction.The patient has a 30-pack-year smoking history and drinks 1 or 2 beers  \noccasionally.Temperature is 38 C(100.4 F),blood pressure is 150/92 mm Hg,pulse is 112/min,and respirations are 26/min.Auscultation revealsnormal lung and heart sounds.There is marked upper abdominal tenderness with guarding.ECG reveals no acute ST-segment or T-wavechanges.Chest x-ray is shown in the image below:  \n|  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- |\n| Scanned by   |       |  |  |  |  |\n|  |  | Camera Scanner  \u003Cbr>旦   | 4   |  | ①   |\n\n1 of 40  \n# Mark卡PreviousNextExit ModeTutorialLab ValuesNotesCalculator\n\n三×  \ntion Id:3178  \nWhich of the following is the most likely cause of this patient's current symptoms?  \n○ A.Acute cholecystitis○ B.Acute gallstone pancreatitis○ C.Aortic dissection○ D.Biliary colic○ E.Perforated peptic ulcer  \nSubmit  \nA AA  \nReverse Color Text Zoom  \nSettings  \nSettings  \nA48-year-old man comes to the office for a routine medical evaluation and is found to have a skin lesion on his upper back.The patient is unsurewhen the lesion appeared but first noticed it several weeks ago during a shower.It is not painful,and he has no other symptoms.He has nochronic medical conditions and takes no medications.The patient drinks 1 or 2 beers nightly and does not use tobacco or illicit drugs.He worksas a surfing instructor.Vital signs are within normal limits.Skin examination findings are shown in the exhibit.The remainder of the examinationis normal.Which of the following is the most likely diagnosis?○ A.Angiosarcoma○ B.Basal cell carcinoma○ C.Cherry hemangioma○ D.Keratoacanthoma○ E.Malignant melanomaO F.Seborrheic keratosis  \nSubmit  \n只  \n三×  \nThis patient developed a nodular,hyperpigmented lesion on an area of skin that likely gets excessive sun exposure while he surfs,raising strongsuspicion for nodular malignant melanoma.  \nIn contrast to superficial spreading melanoma,which grows horizontally along the dermal layer,nodular melanoma grows vertically.Therefore,itoften presents with few of the classic ABCDE criteria.Most cases are marked by a darkly pigmented lesion with uniform color and symmetricborders;however,suspicion is generally raised due to the presence of ≥1 of the following features:  \n·The \"ugly duckling sign\"-patients with several pigmented cutaneous lesions (nevi)usually have lesions that all appear somewhat similar.When a single lesion looks significantly different from the others this is called the \"ugly duckling sign\";it has a high sensitivity (up to 90%)formelanoma.  \n·Elevation from surrounding skin(eg,nodular,pedunculated)  \n·Firm to palpation  \n·Continuous growth over a month  \nThe diagnosis is generally confirmed by full-thickness excisional biopsy.  \n(Choices A and C)Dermal angiosarcoma is a rare disorder that most commonly occurs in patients with prior radiation therapy.Cherryhemangioma is a common,benign lesion composed of congested capillaries and postcapillary venules in the papillary dermis.These disordersare usually heavily vascular(eg,bright red).  \n(Choice B)Basal cell carcinoma is a common skin malignancy that typically appears as an enlarging fleshy nodule with ulceration.It isassociated with sun exposure and is most common on the face,neck,and extremities.  \n(Choice D)Keratoacanthomas are nonpigmented cutaneous tumors that usually present as dome-shaped nodules with a central keratinous plug.  \n(Choice F)Seborrheic keratosis is a benign pigmented lesion with a well-demarcated border and a velvety or greasy surface.It can ","cbCaisl7EcrAEgXY","https://ap.wps.com/l/cbCaisl7EcrAEgXY","pdf",44993243,154,"English","# Case prompt and differential options\n## ABCDE criteria and limitations for nodular melanoma\n## Clinical warning features to raise suspicion\n## Diagnostic confirmation and learning objective","[{\"question\":\"Why are the ABCDE criteria less sensitive for nodular melanoma?\",\"answer\":\"Nodular melanoma often grows vertically, so lesions may show fewer classic ABCDE features compared with superficial spreading melanoma. The material notes that ABCDE assists most with superficial spreading, but is less sensitive for other melanoma types like nodular or atypical.\"},{\"question\":\"What features should raise suspicion for nodular malignant melanoma?\",\"answer\":\"Suspicion increases with one or more features such as the “ugly duckling sign,” elevation from surrounding skin, firm palpation, and continuous growth over a month.\"},{\"question\":\"How is melanoma diagnosis generally confirmed?\",\"answer\":\"The document states that diagnosis is generally confirmed by a full-thickness excisional biopsy.\"}]","Melanoma - Most likely diagnosis and ABCDE criteria | PDF",1791592499,388]