Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma - 14/06/12
, Josep Malvehy, MD, PhD a, b
Reprint requests: Susana Puig, MD, PhD, Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, Villarroel 170, 08036 Barcelona, Spain.Abstract |
Background |
Early detection of melanoma is the best way to improve prognosis. Digital follow-up (DFU) programs of populations at high risk could be an efficient strategy for detecting early melanomas with low morbidity.
Objective |
We sought to report the added value of the use of the “two-step method” (digital total body photography and digital dermatoscopy).
Methods |
This was an analysis of the surveillance of 618 patients at high risk for melanoma included in our DFU program from 1999 to 2008.
Results |
A total of 11,396 lesions were monitored (mean 18.44/patient) during a median follow-up of 96 months (median 10 visits/patient). A total of 1152 lesions, 1.86 per patient, were excised. Almost 70% (798) were lesions previously registered at least twice, whereas 356 (30%) were detected and removed in the same visit. During follow-up, 98 melanomas (8.5% of excised lesions) were diagnosed in 78 patients (12.6%). In all, 53 melanomas were in situ (53.3%), whereas invasive (45) showed a Breslow index of less than 1 mm (median 0.5 mm) and none were ulcerated.
Limitations |
Because there are no control groups we cannot determine if the combined use of total body photography and digital dermatoscopy is more beneficial than these techniques used separately.
Conclusion |
DFU with total body photography and dermatoscopy in a selected population at high risk demonstrated the early detection of melanomas with a low rate of excisions. Long-term follow-up is required to allow the detection of slow-growing melanomas. Based on our 10-year experience, melanomas can be diagnosed at any time, suggesting that in a population at high risk for melanoma, DFU should be maintained over time.
Le texte complet de cet article est disponible en PDF.Key words : atypical mole syndrome, dermatoscopy, follow-up, imaging techniques, malignant melanoma, outcome
Abbreviations used : AMS, DFU, MM, TBP
Plan
| Funding sources: The research at the melanoma unit in Barcelona is partially funded by grants 03/0019, 05/0302, and 06/0265 from Fondo de Investigaciones Sanitarias, Spain; by the CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain; by the Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR) 2009 SGR (Suport a grups de recerca) 1337 of the Catalan Government, Spain; by the European Commission under the Sixth Framework Programme, contract No. LSHC-CT-2006-018702 (GenoMEL); and by the National Cancer Institute of the US National Institutes of Health (CA83115). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript. |
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| Conflicts of interest: None declared. |
Vol 67 - N° 1
P. e17-e27 - juillet 2012 Retour au numéro
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