Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy: do melanomas and nevi already differ at baseline?

Background: What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. Objective: To compare the grade of atypia of melanomas and nevi of the same patient at baseline. Methods: Prospective observational study using 236 dermatoscop...

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Main Authors: Tschandl, Philipp (Author) , Müller-Christmann, Christine (Author) , Hänßle, Holger (Author)
Format: Article (Journal)
Language:English
Published: 2017
In: Journal of the European Academy of Dermatology and Venereology
Year: 2016, Volume: 31, Issue: 6, Pages: 972-977
ISSN:1468-3083
DOI:10.1111/jdv.14065
Online Access:Verlag, Pay-per-use, Volltext: http://dx.doi.org/10.1111/jdv.14065
Verlag, Pay-per-use, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.14065
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Author Notes:P. Tschandl, L. Hofmann, C. Fink, H. Kittler, H.A. Haenssle
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Summary:Background: What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. Objective: To compare the grade of atypia of melanomas and nevi of the same patient at baseline. Methods: Prospective observational study using 236 dermatoscopic baseline images (59 quartets from 59 patients, each including one melanoma detected during follow-up and three nevi). Dermatologists (n = 26) were asked to assess the ‘grade of dermatoscopic atypia’ on a numerical scale and to identify the melanomas. Results: On average, each dermatologist identified 24 of 59 melanomas (40%, range: 11-37). The number of correct picks was greater for dermatologists with moderate (mean: 28) or high (mean: 28) experience compared to beginners (mean 17; P < 0.001). In three of the 59 sets, none of the 26 dermatologists identified the melanoma. The mean grade of dermatoscopic atypia was 2.5 for nevi (95% CI: 2.4-2.6) and 3.0 for melanomas (95% CI: 2.9-3.1, P < 0.001). Limitations: Rating dermatologists were informed that each quartet of images included one melanoma creating substantial deviation from a real-life situation. Conclusion: A significant proportion of melanomas detected during follow-up cannot be differentiated from nevi at baseline. This necessitates the additional inclusion of less atypical lesions for monitoring.
Item Description:Gesehen am 07.09.2018
Article was first published on 29 November 2016
Physical Description:Online Resource
ISSN:1468-3083
DOI:10.1111/jdv.14065