TY - JOUR
T1 - Selection of patients for long-term surveillance with digital dermoscopy by assessment of melanoma risk factors
AU - Haenssle, Holger A.
AU - Korpas, Bianca
AU - Hansen-Hagge, Christian
AU - Buhl, Timo
AU - Kaune, Kjell M.
AU - Johnsen, Steven
AU - Rosenberger, Albert
AU - Schön, Michael P.
AU - Emmert, Steffen
PY - 2010/3
Y1 - 2010/3
N2 - 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.
AB - 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.
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U2 - 10.1001/archdermatol.2009.370
DO - 10.1001/archdermatol.2009.370
M3 - Article
C2 - 20231495
AN - SCOPUS:77949401406
SN - 0003-987X
VL - 146
SP - 257
EP - 264
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 3
ER -