Assessment of the Optimal Interval for and Sensitivity of Short-term Sequential Digital Dermoscopy Monitoring for the Diagnosis of Melanoma

Abstract

To determine whether 6 weeks could replace 3 months for short-term sequential digital dermoscopy imaging (ST-SDDI) of suspicious melanocytic lesions and determine the proportion of melanomas missed.Design: Consecutive lesions (n=2602) undergoing ST-SDDI monitored from 1859 patients were included. Half of the patients underwent 6-week monitoring followed by 3-month monitoring (range, 2.5-4.5 months) if changes were not seen. The remainder underwent 3-month monitoring only. Any change during this time led to excision. Lesions unchanged were then followed up over time.Setting: A tertiary referral institution. Main Outcome Measures:The proportion of changed melanomas (sensitivity) and odds ratios (ORs) for melanoma of changed lesions.

Patient Ability to Take Dermoscopic Follow-Up Images of Atypical Melanocytic Lesions With Smartphones: A Pilot Study

“…Short-term teledermoscopic monitoring of AMLs has previously been shown to be safe and accurate. An excision rate of 9.1% in the present study (six lesions after short-term monitoring and an additional six lesions after further monitoring) was similar to the excision rate observed in a previous study by Berglund et al (8.6%) but slightly lower than the excision rates observed by Altamura et al and Menzies et al (18.7–22.3%) [ 2 – 4 ]. This discrepancy might be explained by the option of continued monitoring after another 4–6 months, which was offered to selected patients in which possible dermoscopic changes were difficult to assess at the first follow-up visit.…”

Diagnostic accuracy and safety of short‐term teledermoscopic monitoring of atypical melanocytic lesions

“…Consequently, the specificity for STTM was slightly higher than previously reported specificities of 83%–84% with STDM . In accordance with Altamura et al ., the sensitivity for detecting melanomas with STTM and STDM seems to be around 90% . In both studies, sensitivities and specificities were based on the assumption that no more melanomas would be discovered in the group without further follow‐ups.…”

“…The number of AMLs needed to be monitored in order to detect one melanoma with the STTM routines studied here were in line with those seen in prior studies on STDM (32.7 vs. 28.9) . However, the number needed to excise was lower in the present study (3.2 vs. 6.5) . Consequently, the specificity for STTM was slightly higher than previously reported specificities of 83%–84% with STDM .…”

“…Prior studies report a higher percentage of changed lesions (18%‐19%) following STDM alone but also a lower percentage of melanomas found among these lesions (11%–17%) . The number of AMLs needed to be monitored in order to detect one melanoma with the STTM routines studied here were in line with those seen in prior studies on STDM (32.7 vs. 28.9) . However, the number needed to excise was lower in the present study (3.2 vs. 6.5) .…”

Availability of digital dermoscopy in daily practice dramatically reduces the number of excised melanocytic lesions: results from an observational study

“…However, Table 5 should be interpreted keeping in mind that in Belgium, the high suspicion of melanoma allows immediate access to university hospital care. This may explain the relatively high mean Breslow thickness in group C. Results of group C2 (patients in whom DD was used) are consistent with previous studies 5,14,19,20 and confirm the safety of the technique: more than one‐third out of all the melanomas were in situ , and the mean Breslow thickness among invasive melanomas was 0·32 mm. The highest Breslow thickness (1·05 mm) was diagnosed in a patient with xeroderma pigmentosum and multiple melanomas.…”