Digital Dermoscopic Monitoring of Atypical Nevi in Patients at Risk for Melanoma

Fuller, Stanley R.; Bowen, Glen M.; Tanner, Ben; Florell, Scott R.; Grossman, Douglas

doi:10.1111/j.1524-4725.2007.33254.x

Cited by 48 publications

(67 citation statements)

References 22 publications

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“…On the other hand, in protocols of digital dermoscopy in which TBP are performed, body-maps are only registered in the first visits, and in subsequent controls body surface is simply compared with overview images. Already in 2007, Fuller et al 4 highlighted that it is unclear in most previous studies whether any MM was missed because they either presented as new lesions or arose from nevi that were not monitored by dermoscopy, since the total number of MM occurring in those patients was not reported. In the latter study, only one MM was detected by DFU out of 6 MMs detected during a median of 22 months; with a MM/benign lesion ratio of 1:94 and 1:34.4 among lesions with and without previous dermoscopy record respectively.…”

Section: Discussionmentioning

confidence: 99%

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Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma

Salerni

Carrera

Lovatto

et al. 2012

Journal of the American Academy of Dermatology

188

170

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Background Early detection of melanoma is the best way to improve prognosis. Digital follow up (DFU) programs of high-risk populations could be an efficient strategy for detecting early melanomas with low morbidity. Objective to report the added value of the use of the “two-step method” (digital total-body photography and digital dermoscopy) Methods Analysis of the surveillance of 618 high-risk melanoma patients included in our DFU-program from 1999 to 2008. Results A total of 11396 lesions were monitored (mean 18.44 per patient) during a median follow-up of 96 months (median 10 visits per patient). 1152 lesions, 1.86 per patient, were excised. Almost 70% (798) were lesions previously registered at least twice, while 356 (30%) were detected and removed in the same visit. During follow-up, 98 melanomas (8.5% of excised lesions) were diagnosed in 78 patients (12.6%). 53 melanomas were in situ (53.3%), while invasive (45) showed a Breslow index of less than 1 mm (median 0.5 mm) and none was ulcerated. Limitations Since there are no control groups we cannot convey if the combined use of total-body photography and digital dermoscopy is more beneficial than these techniques used separately. Conclusion DFU with Total-Body Photography and Dermoscopy in a selected high-risk population demonstrated the early detection of melanomas with a low rate of excisions. Long-term follow-up is required to allow the detection of slow growing melanomas. Based on our 10-year experience, melanomas can be diagnosed at any time, suggesting that in high-risk population, DFU should be maintained with time.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, it has been suggested that a screening strategy focused solely on atypical nevi will likely misdiagnose MM presenting as new lesions or corresponding to lesions not considered adequate for digital follow-up 4 .…”

Section: Introductionmentioning

confidence: 99%

Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma

Salerni

Carrera

Lovatto

et al. 2012

Journal of the American Academy of Dermatology

188

170

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“…A clinical study by an Australian group found that the biopsy ratios for general practitioners ranged from 82:1 for young patients to 10:1 for older patients. The biopsy ratio appears to be substantially reduced with the use of newer technologies such as dermoscopy, surface microscopy, and multispectral imaging (28,(30)(31)(32)(33)(34)(35)(36)(37)(38). Westerhoff and colleagues found that the accuracy of melanoma diagnosis could be improved from 63% to 76% with the aid of surface microscopy (30).…”

Section: Discussionmentioning

confidence: 99%

Real-time Raman Spectroscopy for In Vivo Skin Cancer Diagnosis

et al. 2012

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Raman spectroscopy is a noninvasive optical technique capable of measuring vibrational modes of biomolecules within viable tissues. In this study, we evaluated the application of an integrated real-time system of Raman spectroscopy for in vivo skin cancer diagnosis. Benign and malignant skin lesions (n ¼ 518) from 453 patients were measured within 1 second each, including melanomas, basal cell carcinomas, squamous cell carcinomas, actinic keratoses, atypical nevi, melanocytic nevi, blue nevi, and seborrheic keratoses. Lesion classification was made using a principal component with general discriminant analysis and partial least-squares in three distinct discrimination tasks: skin cancers and precancers from benign skin lesions [receiver operating characteristic (ROC) ¼ 0.879]; melanomas from nonmelanoma pigmented lesions (ROC ¼ 0.823); and melanomas from seborrheic keratoses (ROC ¼ 0.898). For sensitivities between 95% and 99%, the specificities ranged between 15% and 54%. Our findings establish that real-time Raman spectroscopy can be used to distinguish malignant from benign skin lesions with good diagnostic accuracy comparable with clinical examination and other opticalbased methods. Cancer Res; 72(10); 2491-500. Ó2012 AACR.

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“…65,66 Whereas this approach appears sensitive for early melanoma detection in that a relatively higher percentage of melanomas were diagnosed as in situ, some melanomas might have been missed because they either presented as new lesions or arose from nevi that were not serially monitored. 67 Dermoscopy can increase or decrease confidence that a melanocytic lesion is benign or malignant, 68,69 thereby improving the early detection of melanoma, while reducing the need for unnecessary biopsies. 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.…”

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

342

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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Digital Dermoscopic Monitoring of Atypical Nevi in Patients at Risk for Melanoma

Abstract: Background-Atypical nevi are a common risk factor for melanoma.

Cited by 48 publications

References 22 publications

Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma

Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma

Real-time Raman Spectroscopy for In Vivo Skin Cancer Diagnosis

The Evolution of Melanoma Diagnosis: 25 Years Beyond the ABCDs

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