A 49-year-old White woman presents to the nurse practitioner with a chief complaint of a mole that has started itching and bleeding. Upon assessment, the nurse practitioner identifies the characteristics of the mole by the acronym ABCDE. Which letter of this assessment represents suspicion of a malignant melanoma?

Choice A reason: Absence of asymmetry reduces suspicion for melanoma. Malignant lesions are often asymmetric, meaning one half does not match the other. A symmetric mole is less concerning. Choice B reason: A regular border is typical of benign lesions. Irregular, notched, or poorly defined borders raise concern for malignancy. Since the border is not irregular, this feature does not support melanoma. Choice C reason: Color variation, especially with blue, black, or multiple tones within a single lesion, is a hallmark of malignant melanoma. Uneven pigmentation suggests abnormal melanocyte activity and warrants further evaluation. Choice D reason: A diameter of 1 cm is borderline. Lesions larger than 6 mm (about the size of a pencil eraser) are considered suspicious, but size alone is not diagnostic. Color variation is more specific in this context.