Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocols

Argenziano, Giuseppe; Mordente, Ines; Ferrara, Gerardo; Sgambato, Anna; Annese, Pietro; Zalaudek, Iris

doi:10.1111/j.1365-2133.2008.08649.x

Cited by 107 publications

(89 citation statements)

References 19 publications

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“…70,71 Regular annual follow up monitoring is also needed to detect slow-growing melanomas in which subtle changes may become apparent only over time. 72 Careful observation with particular attention to evolving changes in appearance should direct which lesions are biopsied or removed. The downside of dermoscopy is its potential failure to detect very early or "featureless" (amelanotic) melanomas.…”

Section: Using Technology To Augment Early Melanoma Diagnosis Dermoscopymentioning

confidence: 99%

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

Rigel

Russak

Friedman

2010

CA: A Cancer Journal for Clinicians

341

274

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Early detection of malignant melanoma remains the key factor in lowering mortality from this cancer. Recognizing the importance of this issue 25 years ago, our group at New York University published in CA: A Cancer Journal for Clinicians the mnemonic "ABCD" to facilitate the early diagnosis of melanoma. Studies have demonstrated the usefulness of this paradigm in enhancing early melanoma diagnosis as a part of clinical examinations, mass screenings, and public education programs. Approaches to melanoma diagnosis have dynamically evolved during the ensuing quarter century. In the 1990s, dermoscopy enabled the recognition of new subsurface features to differentiate between malignant and benign pigmented lesions. During the last decade, new computer-based technologies have improved diagnostic sensitivity and specificity and may result in optimizing lesion selection for biopsy and pathology review. Despite all of the advances in melanoma diagnosis, timely recognition, detection, and rapid treatment of melanoma remain critical. Although pathologic examination remains the gold standard for diagnosis, this cancer has the potential to be diagnosed through noninvasive approaches because of its cutaneous location. From the development of the ABCDs through current attempts that use complex computer algorithms and genetic markers, a clinician's ability to detect melanoma in its earliest form has been augmented. However, a "good clinical eye" is still fundamental to selecting the lesions for evaluation among the sea of those that are prevalent. As current approaches are refined and new techniques are developed, the improved ability to diagnose this cancer will hopefully enhance reaching the goal of reducing melanoma mortality. CA Cancer J Clin 2010;60:301-316.

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Section: Using Technology To Augment Early Melanoma Diagnosis Dermoscopymentioning

confidence: 99%

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

Rigel

Russak

Friedman

2010

CA: A Cancer Journal for Clinicians

341

274

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“…Thin MMs, however, especially when in situ, are difficult to diagnose [5] and, although sequential dermoscopy imaging allows the detection of MMs which lack dermoscopic features at baseline [6,7], it is not always applicable and, furthermore, it is entirely based on the patient’s compliance [8]. Thus, it would be ideal to have at one’s disposal dermoscopic criteria dedicated to the detection of very early MMs, enabling the identification of in situ lesions at the first examination.…”

Section: Introductionmentioning

confidence: 99%

Variegated Dermoscopy of in situ Melanoma

Seidenari

Bassoli²,

Borsari³

et al. 2012

Dermatology

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Background: Melanomas in situ (MIS) are difficult to diagnose, lacking well-established dermoscopic descriptors. Objective: The aim of this study was toimprove the identification of early melanomas describing the variegated dermoscopic features of MIS and their correlation with demographic and clinical aspects. Methods: Dermoscopic images of 114 histologically proven MIS were evaluated by 3 expert dermoscopists and classified into their main dermoscopic patterns. Dermoscopic features were also considered for their correlation with clinical parameters. Results: Eight different dermoscopic subtypes of MIS were identified: reticular grey-blue (27.2%), reticular (21.1%), multicomponent (20.2%), island (10.5%), spitzoid (7%), inverse network (6.1%), ‘net-blue globules’ (5.3%) and globular (2.6%). Clinical characteristics of lesions and patients varied according to the different dermoscopic groups. Conclusion: We hypothesize that the different dermoscopic subgroups of MIS correspond to lesions with a different origin and, possibly, various patterns of growth and a different biological behaviour.

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“…The possibility that a patient may not turn up for the subsequent follow-up should also be taken into account [10,16,17,18,19,20,21,22,23]. However, it is clear that melanocytic lesions with features of nevus-like melanoma can benefit from short-term digital monitoring [21].…”

Section: Discussionmentioning

confidence: 99%

Impact of Mole Mapping in the Italian Health System

et al. 2013

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Objective: To analyze routine clinical management of atypical melanocytic lesions through monitoring or surgery in Italian hospitals. Methods: A nationwide survey of clinical practices was conducted. Results: Digital monitoring is performed in most Italian hospitals and is preferred over excision for single atypical melanocytic lesions in 82% of hospitals. For multiple atypical lesions, 60% of high-volume hospitals prefer digital monitoring to surgical excision (40%). There is a statistically significant difference between high- and low-volume hospitals (60 vs. 39%; p = 0.003). Digital monitoring is performed at mean intervals of 4/5 months for both types of lesions. Conclusions: We show an asymmetric relation between application of the method and practical impact based on available clinical evidence. Although digital monitoring provides better characterization of the evolution of melanocytic lesions, our results indicate that the advantages and limitations of this method require further investigation.

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Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocols

Cited by 107 publications

References 19 publications

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

Variegated Dermoscopy of in situ Melanoma

Impact of Mole Mapping in the Italian Health System

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