Difference maker

January 1, 2006

Darrell S. Rigel, M.D., a dermatologist and clinical professor, New York University Medical Center, New York, has spent 27 years in dermatology focusing on issues related to prognosis and prevention of skin cancer, and his contributions have been numerous.

In fact, skin cancer issues are what lured him into the specialty as an intern in internal medicine at New York Hospital at Cornell. Dr. Rigel was considering going into cardiology until he heard a grand rounds presentation by Alfred Kopf, M.D., professor of dermatology at NYU. Dr. Kopf talked about how he and colleagues had put together a database on melanoma and presented some early findings. He then asked the interns if anyone had suggestions on how to mine the database.

Dr. Rigel, who was a Massachusetts Institute of Technology (MIT) graduate with a bachelor's and master in computer science, had plenty of ideas.

Easy as ABC

Dr. Rigel went on to amass accomplishments in his chosen field.

He and dermatologist Robert Friedman, M.D., coined the universally used acronym, the ABCDs of melanoma, describing the four warning signs of early melanoma.

It was 1984, "We were trying to think of ways to describe early melanoma so that people could understand what it was and detect it earlier," Dr. Rigel says

After quizzing colleagues slides of melanoma, "We concluded that, if you have seen enough of these, it is almost like a gestalt kind of thing," Dr. Rigel says.

They then went through the entire alphabet, linking letters to melanoma identification.

"We realized that the system to recognize early melanoma had to be as easy as ABC".

Looking at tell-tale features of skin cancer, the doctors came up with A for asymmetry; B for border irregularity; and C for color unevenness.

They took the idea to Dr. Kopf, who pointed out that some small lesions are not always melanoma.

"So, we went to the NYU Melanoma Cooperative Group database and found out that 95 percent of melanomas were bigger than 6 mm, or about a quarter inch. That became the D, for diameter," Dr. Rigel says.

Hence, the birth of the ABCDs of melanoma. The doctors took their concept in fall 1984 to the American Academy of Dermatology (AAD) and the American Cancer Society, in an effort to have the two groups collaborate on sending out the message. The plan worked and led to the first joint specialty publication ever in CA, the American Cancer Society's journal, in January-February 1985, featuring an article on the ABCDs of melanoma.

"It is very rare in life that you have the opportunity to do something where what you develop becomes a generally accepted concept," he says.

The ABCDs of melanoma has been translated into about 12 languages, according to Dr. Rigel.

"I cannot tell you how many people who, over the years, have come up to us and said 'you have saved our life with this,'" Dr. Rigel says. "That is probably the biggest contribution we have personally made over the years in skin cancer."

Ardent advocate

Dr. Rigel's professional life has always focused on his involvement in organized dermatology.