Seven-point checklist for dermatoscopy: Performance during 10 years of prospective surveillance of patients at increased melanoma risk

Variegated Dermoscopy of in situ Melanoma

“…An irregular pigment network is found in most MIS, whereas it is observed in a minority of invasive tumours [20,21]. …”

“…Carli et al [22] observed that the mean total dermoscopic score for MIS was less than the diagnostic threshold for MMs. Evaluating 50 MIS by the 7-point checklist in a prospective study, Haenssle et al [21] observed that 22% of the lesions scored 1 point and 14% 4 points, thus concluding that a trend towards a lower 7-point checklist score for MIS makes the differentiation from atypical naevi difficult going solely by the 7-point checklist.…”

Dermatoscopy for Melanoma and Pigmented Lesions

“…The ASAP approach has not yet been evaluated in a retrospective study; however, studies have shown that using dermatoscopy based on the decision to biopsy or not results in significant improvement in sensitivity. 26 Although some studies have reported sensitivity levels as high as 98% achieved by the CASH algorithm, a prospective study by Haenssle and colleagues 27 reinforces the fact that these algorithms are meant to support, not supplant, clinical judgment. The 7-point checklist was studied in a 10-year prospective surveillance of patients at high risk for melanoma.…”

“…The use of complementary information such as lesional history or dynamic changes detected through digital dermatoscopy were responsible for diagnosing these melanomas that were missed through the algorithm alone. 27 …”

Non-Invasive Determination of Breslow Index

“…Carli et al showed that a 6.8 dermatoscopic score allowed a 79%-positive predictive value for classification of melanomas into two groups of Breslow index less than or greater than 0.55 mm (Carli, de Giorgi et al 2000). However Haenssle (Haenssle, Korpas et al 2009) chose to use the 7-point checklist as this algorithm can be learned and applied more easily by nonexperts (e.g., residents in dermatology) while still allowing a high sensitivity. They carried out a 10 year-prospective clinical study on 688 patients at increased melanoma risk detecting a total of 127 melanomas.…”