A nurse is performing a skin assessment on a 70-year-old client and notes a new asymmetric lesion on the client's back with irregular borders, multiple colors (brown, black, and red), and a diameter of 7 mm. What is the priority nursing action?

The ABCDE RULE is the standard skin cancer screening tool for identifying lesions suspicious for MELANOMA — the most dangerous form of skin cancer: A — ASYMMETRY: one half doesn't match the other (normal moles are symmetrical); B — BORDER: irregular, ragged, notched, or blurred edges (normal moles have smooth borders); C — COLOR: multiple colors in one lesion — shades of tan, brown, black, red, white, or blue (normal moles are uniform in color); D — DIAMETER: larger than 6 mm (about the size of a pencil eraser) — though melanomas can be smaller; E — EVOLUTION (CHANGE): any change in size, shape, color, or appearance, or any new symptom such as bleeding, itching, or crusting. The lesion described has multiple concerning features: ASYMMETRIC, IRREGULAR BORDERS, MULTIPLE COLORS (brown, black, red), and DIAMETER >6 mm — all four classic warning signs.

Priority action: this requires URGENT referral to the provider for dermatologic evaluation, not watchful waiting.

Priority: early melanoma detected before spreading has a 5-year survival rate of >98%; late-stage melanoma (with metastasis) has a 5-year survival rate of approximately 30%. RISK FACTORS for skin cancer: UV exposure (sun, tanning beds); fair skin, light eyes/hair; history of sunburns; personal or family history of skin cancer; immunosuppression; ABCDE lesion characteristics.

Nursing role: perform systematic skin assessments (head-to-toe); use ABCDE criteria; document findings accurately (size, location, color, borders, appearance); report new or changing lesions to provider; patient education about sun protection (SPF 30+, protective clothing, avoid peak UV hours 10am-4pm, avoid tanning beds).