HISTORY. Reports of a change in a nevus or mole or a new skin lesion require careful follow-up. Ask the patient the following questions: When did the lesion first appear or change? What is the specific nature of the change? What symptoms and characteristics of the lesion has the patient noticed? What is the patient's history of exposure to ultraviolet light or radiation? What is the history of thermal or chemical trauma? What personal or family history of melanoma or precancerous lesions exists?

PHYSICAL EXAMINATION. To identify potentially cancerous lesions, inspect and palpate the scalp, all skin surfaces, and the accessible mucosa. Examine pre existing lesions, scars, freckles, moles, warts, and nevi closely. The "ABCD rule" can be useful in identifying distinguishing characteristics of suspicious lesions (Table 1).

• TABLE 1 ABCD Rule of Assessment for Melanoma
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