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Journal of the American Academy of Dermatology
Volume 42, n° 5P1
pages 754-759 (mai 2000)
Doi : 10.1067/mjd.2000.104895
accepted : 9 December 1999
Detection of artificial changes in mole size by skin self-examination
 

Channy Y. Muhn, MD, BSc(Hons)b, Lynn From, MD, FRCPCa, Michelle Glied, MDa
Toronto and Hamilton, Ontario, Canada 
From the Division of Dermatology, Toronto Sunnybrook Regional Cancer Centre, University of Toronto,a and from McMaster University, Hamilton.b 

Abstract

Background: The efficacy of the skin self-examination (SSE) to detect artificial changes in the size of nevi has not been evaluated in a controlled setting. Objective: Our purpose was to determine the sensitivity and specificity of the SSE in detecting artificial changes in mole size in patients at high risk for melanoma. Methods: In a single-center, single-blinded cross-over study, patients who had been performing the SSE confidently for at least 1 year examined their backs after the diameter of an existing mole was increased artificially in random order by 0, 2, or 4 mm. Results: The specificity of the SSE was 62% (95% confidence interval [CI], 53%-72%) (N = 103). The sensitivity of the 2 mm change was 58% (95% CI, 49%-68%) and that of the 4 mm change was 75% (95% CI, 66%-83%). SSE performance was not related to perceived risk, number of moles, gender, age, or frequency of self-examination. Conclusion: Even in our highly motivated and selected group of high-risk patients, 25% could not detect an obvious increase in the diameter of an existing nevus, whereas 38% incorrectly identified a change when none was made. The SSE is only a moderately effective tool for the detection of acute, large, changes in mole size. The usefulness of the SSE in detection of new lesions or changes in existing lesions is likely due to a combination of factors or due to factors other than size, such as color, border irregularity, and texture, among others. (J Am Acad Dermatol 2000;42:754-9.)

The full text of this article is available in PDF format.

 Supported by two Medical Research Council of Canada Scholarships (to C. M.).
 Reprint requests: Dr Lynn From, Division of Dermatology, Sunnybrook and Women’s College Health Sciences Centre, 76 Grenville St, Toronto, Ontario, Canada, M5S 1B2.



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