What are the key clinical features to identify a suspicious mole that may indicate melanoma?

To identify a suspicious mole that may indicate melanoma, key clinical features are assessed using the 7-point checklist or the ABCDE system ¹,².

• 7-point checklist: A score of 3 or more on this checklist warrants an urgent referral via a suspected cancer pathway for an appointment within 2 weeks ¹,²,³. The presence of any major feature from this checklist is an indication for referral ¹,². Minor features should increase suspicion ¹,².
• ABCDE system: Any features identified using the ABCDE system are also an indication for referral ¹,².

Other features that suggest a suspicious lesion and warrant urgent referral include:

• Dermoscopy suggesting melanoma ¹,².
• New pigmented lines in the nail, especially if associated with nail damage, or a lesion growing under the nail ¹,².
• A new, persistent skin condition that is growing, pigmented, or vascular in appearance, where the diagnosis is unclear ¹,².
• Any doubt about the lesion, or a history of recent change ¹,².
• A pigmented or non-pigmented skin lesion that suggests nodular melanoma ¹,².

When assessing a lesion, important historical information includes how long it has been present, changes in size, colour, or shape, and symptoms such as itching or bleeding ¹,². Examination should note the lesion's location, size, elevation (flat, palpable, nodular), and description (e.g., irregular margins, irregular pigmentation, ulceration), along with any palpable lymph nodes ¹,².