Characterization of 1152 lesions excised over 10 years using total-body photography and digital dermatoscopy in the surveillance of patients at high risk for melanoma - 12/10/12
, Josep Malvehy, MD, PhD a, b
Reprint requests: Susana Puig, MD, PhD, Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036 Barcelona, Spain.Abstract |
Background |
The combined use of total-body photography and digital dermatoscopy, named “two-step method of digital follow-up,” allowed the detection of incipient melanoma as a result of dermatoscopic or macroscopic changes during follow-up.
Objective |
We sought to assess dermatoscopic features and dynamic changes leading to excision of melanocytic lesions during our 10-year experience of monitoring patients at high risk for melanoma.
Methods |
We analyzed 1152 lesions excised during the surveillance of 618 patients at high risk for melanoma from 1999 to 2008.
Results |
A total of 779 excised lesions had been previously recorded: 728 were removed because of dermatoscopic changes during follow-up and 51 were removed even though no significant change was noted. The remaining 373 excised lesions were new or undetected on previous total-body photography. A total of 98 melanomas were detected, 60 in the monitored lesions, and 38 among the “new” lesions. The most frequent dermatoscopic changes detected were asymmetric enlargement in almost 60% (n = 418), focal changes in structure in 197 (27%) and in pigmentation in 122 (17%), the latter two being more frequently seen in melanomas than in nevi (both P < .001). No significant differences were detected between dermatoscopic or histopathological characteristics of the melanomas in each group, with a considerable proportion of melanomas misclassified as benign in both groups (26.3% and 38.3%, respectively).
Limitations |
The dermatoscopy pattern of stable lesions and the histopathology of lesions not removed were not included in the study.
Conclusion |
The most frequent dermatoscopic features associated with melanoma were focal change in pigmentation or structure. Melanomas detected by dermatoscopic changes were remarkably similar to those detected in total-body photography. Almost 40% of melanomas diagnosed in individuals at high risk corresponded to lesions that were not under dermatoscopic surveillance.
Le texte complet de cet article est disponible en PDF.Key words : atypical mole syndrome, dermatoscopy, dysplastic nevus, follow-up, imaging techniques, malignant melanoma, outcome
Abbreviations used : DFU, DM, MM, notDM, TBP
Plan
| The research at the Melanoma Unit, Hospital Clìnic of Barcelona, is partially funded by grants 03/0019, 05/0302, 06/0265, and 09/1393 from Fondo de Investigaciones Sanitarias, Spain; by the CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain; by the AGAUR 2009 SGR 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). |
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| Conflicts of interest: None declared. |
Vol 67 - N° 5
P. 836-845 - novembre 2012 Retour au numéro
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