Selection of patients for long-term surveillance with digital dermoscopy by assessment of melanoma risk factors

Holger A. Haenssle, Bianca Korpas, Christian Hansen-Hagge, Timo Buhl, Kjell M. Kaune, Steven Johnsen, Albert Rosenberger, Michael P. Schön, Steffen Emmert

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Objective: To identify patients at increased melanoma risk who benefit from long-term surveillance with digital dermoscopy. Design: Prospective, nonrandomized, observational study. Setting: University-based surveillance program. Participants: Six hundred eighty-eight patients prospectively categorized into defined melanoma risk groups and followed up (mean, 44.3 months) by clinical examinations, dermoscopy, and, for atypical nevi, sequential digital dermoscopy. Main Outcome Measure: Association between patient risk factors and detection of melanomas. Results: Odds ratios from a multivariate logistic regression analysis indicated a highly increased melanoma risk for patients with familial atypical mole and multiple melanoma (FAMMM) syndrome, atypical mole syndrome (AMS), or previous melanoma. Each digitally documented atypical lesion (range, 1-17 lesions per patient) denoted a significant 10% increase in melanoma risk. Patients with higher melanoma risk (1) showed a higher percentage of melanomas detected by digital dermoscopy( FAMMM syndrome group, 50%; AMS group, 22%), (2) more often developed multiple melanomas within shorter intervals, and (3) showed a ratio of melanoma to benign results for lesions excised because of dynamic changes of 1:15 (AMS group) or 1:4 (FAMMM syndrome group). Melanomas detected by digital dermoscopy were significantly thinner (0.41 mm in mean Breslow thickness) compared with melanomas detected by other means (0.62 mm; P=.04). Conclusions: We suggest an individualized surveillance plan, with digital dermoscopy performed at follow-up intervals of 3 months for patients with FAMMM syndrome and 6 to 12 months (depending on additional risk factors) for those with AMS. Patients with multiple common nevi and no additional risk factors had no benefit from sequential digital dermoscopy.

Original languageEnglish (US)
Pages (from-to)257-264
Number of pages8
JournalArchives of Dermatology
Volume146
Issue number3
DOIs
StatePublished - Mar 1 2010

ASJC Scopus subject areas

  • Dermatology

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    Haenssle, H. A., Korpas, B., Hansen-Hagge, C., Buhl, T., Kaune, K. M., Johnsen, S., Rosenberger, A., Schön, M. P., & Emmert, S. (2010). Selection of patients for long-term surveillance with digital dermoscopy by assessment of melanoma risk factors. Archives of Dermatology, 146(3), 257-264. https://doi.org/10.1001/archdermatol.2009.370