A skin lesion exhibiting features that match one or more of the ABCDE criteria should be investigated:

• asymmetry
• border irregularity
• colour
• diameter of the skin lesion
• evolving and/or the following:
• itching, scaling, bleeding, oozing, swelling or pain in a skin lesion
• new lesions, lesions noted to be changing or lesions that do not heal or respond to treatment
• a rapidly growing skin lesion persistent after one month
• spread of pigment from a lesion to the surrounding tissue.

The presence of multiple signs and symptoms, particularly in combination with other underlying risk factors, indicates an increased risk of melanoma.

Note: A small percentage of cases present as a symmetrical, often non-pigmented nodule that grows progressively for over a month (EFG: elevated, firm and growing progressively; Kelly et al. 2003). These are invasive from the outset and grow more quickly (over weeks to months), with elevation, deeper invasion and earlier onset of bleeding and ulceration.