Abcd rule, dermatoscopic

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Semiquantitative evaluation scheme of vital histology for the calculation of a dermoscopic value (DPW) for the grading of a pigment lesion with regard to its malignancy.

General information
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  • Evaluation: The criteria of the dermatoscopic ABCD-rule (asymmetry, limitation, colour, differential structure) are generally recognizable in overview photographs, i.e. at about 10x magnification, and can therefore be described as dermatoscopic characteristics.
    • DPW < 5.45: Benign pigment mark very likely.
    • DPW > 5,45: Malignant melanoma very probable (threshold range: 4,75-5,45).
  • The diagnostic accuracy is 92.2%. About 9.7% of benign melanocytic nevi are wrongly overdiagnosed as malignant according to the dermoscopy rule.

Notice! With a DPW between 4.75 and 5.45 additional information, e.g. whitish regressive areas, vascular patterns or other pigmentary features should be used.

Cave! Amelanotic or nodular melanomas may also have low point values (< 5.45).

Literature
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  1. Proud W, Braun-Falco O, Bilek P, Landthaler M, Burgdorf WHC, Cognetta AB (2002) Color atlas of dermatoscopy. Blackwell, Berlin

Tables
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Feature

Peculiarity

Score

factor*

Asymmetry

in 0, 1 or 2 axes

0-2

x 1,3

Limitation

Abrupt termination of the pigment pattern in 0 to 8 segments

0-8

x 0,1

Colour

white, red, light brown, dark brown, blue grey, black

1-6

x 0,5

Differential structure

Network, unstructured areas, dots, plaice, stripes

1-5

x 0,5

* Coefficient for the calculation of the dermoscopy point value (DPW)

Authors

Last updated on: 29.10.2020