The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas

Abstract

Background:Early recognition is the most important intervention to improve melanoma prognosis.Objective:To report the value of dermoscopy and digital dermoscopy in the clinical diagnosis of malignant melanoma (MM).Methods:Retrospective analysis of 99 consecutive primary MMs diagnosed between 2010 and 2013. The MMs were divided into 3 groups: 1) the MM was the reason for consultation (MMC), 2) the MM was detected during routine control of nevi (MMRC), and 3) the MM was detected due to changes observed during digital dermoscopy follow-up (MMDFU). Clinical, dermoscopic and histologic features were assessed.Results:A total of 99 MMs were diagnosed in 89 patients (55% male) with a mean age of 50.8 (18-93) years. Of all the MMs, 35 were the reason for patient consultation (MMC), 52 were detected during routine control of nevi (MMRC) and 12 were diagnosed due to changes observed with digital dermoscopy (MMDFU). On clinical examination, 74.2 % of MMC met the 4 ABCD criteria, while only 30.7 % of MMRC and 8.3 % of MMDFU. Most MMC were correctly classified as malignant according to dermoscopy, but 44.2% of MMRC and only 16.7% of MMDFU. 22.9% of MMC, 50% of MMRC and 58.3% of MMDFU were in situ. Mean Breslow thickness was significantly lower in the MMDFU group (0.52 mm) than in the MMRC and MMDFU groups (0.77 and 1.43 mm respectively).Conclusions:The use of dermoscopy and digital dermoscopy allows the detection of MMs in early stages, even in the absence of specific criteria for malignancy.

A series of small-diameter melanomas on the legs: dermoscopic clues for early recognition

“…Four melanomas were detected due to changes during digital of high-risk melanoma patients, increase in size with no further significant change were observed in 3 cases; 1 case displayed changes in shape, structures and pigmentation. This supports the fact that digital follow-up allows for the detection of early melanoma, when specific structures or criteria for malignancy may not be present yet [ 7 , 8 ].…”

“…Several strategies such as the ABCD(E) acronym [ 3 , 4 ], the “ugly duckling sign” [ 5 ] or the EFG [ 6 ], just to mention a few, have been proposed to enhance clinical recognition of atypical lesions that should undergo excision or close monitoring, but it usefulness in the detection of melanoma at a curable stage is questionable since only evolved lesions fulfil clinical criteria [ 7 , 8 ].…”

Multiple Primary Invasive Small-Diameter Melanomas: Importance of Dermoscopy And Digital Follow-Up

“…The comparison of sequential dermoscopic images of melanocytic lesions in search of subtle changes over time has been helpful in the diagnosis of early melanomas, which might lack specific criteria for malignancy [1]. In addition, the use of baseline regional photographs might facilitate the detection of new lesions, and visual changes in preexisting lesions, by providing a comparative reference for subsequent examinations [2].…”

The skin microbiopsy

“…The utility of these imaging modalities were established mostly in screening and diagnosis of melanoma (Ferrari et al, 2014, Salerni et al, 2014, de Giorgi et al, 2005. Dermoscopy and reflectance confocal microscopy (RCM) are one of the few imaging modalities which have shown promising results for accurate diagnosis of non-melanoma skin cancer (Longo et al, 2014a, Ulrich et al, 2008, Rishpon et al, 2009, Peppelman et al, 2014).…”

“…The use of dermoscopy in combination with total body photography was proven beneficial in early diagnoses of skin cancer (Salerni et al, 2014). …”