Total body photography for secondary prevention of melanoma

Kittler, Harald

doi:10.1111/bjd.20058

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Most melanomas detected by TBP were in situ, highlighting the impact of TBP for early recognition. TBP is especially useful for individuals with multiple nevi, in whom melanomas are more difficult to detect because of the abundance of nevi [27].…”

Section: The Disadvantage Of the Newly Added E Criterion Relies Onmentioning

confidence: 99%

Evolution of the Clinical, Dermoscopic and Pathologic Diagnosis of Melanoma

Kittler

2021

Dermatol Pract Concept

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The conventional narrative states that the steadily rising incidence of melanoma among fair-skinned Caucasian populations during the last decades is caused by excessive UV-exposure. There is, however, no doubt that other factors had a significant impact on the rising incidence of melanoma. Pre-1980s the clinical diagnosis of melanoma was based on gross criteria such as ulceration or bleeding. Melanomas were often diagnosed in advanced stages when the prognosis was grim. In the mid-1980s education campaigns such as the propagation of the ABCD criteria, which addressed health care professionals and the public alike, shifted the focus towards early recognition. Dermatoscopy, which became increasingly popular in the mid-1990s, improved the accuracy for the diagnosis of melanoma in comparison to inspection with the unaided eye, especially for flat and small lesions lacking ABCD criteria. At the same time, pathologists began to lower their thresholds, particularly for the diagnosis of melanoma in situ. The melanoma epidemic that followed was mainly driven by an increase in the number of in situ or microinvasive melanomas. In a few decades, the landscape shifted from an undercalling to an overcalling of melanomas, a development that is now met with increased criticism. The gold standard of melanoma diagnosis is still conventional pathology, which is faced with low to moderate interobserver agreement. New insights in the molecular landscape of melanoma did not translate into techniques for the reliable diagnosis of gray zone lesions including small lesions. The aim of this review is to put our current view of melanoma diagnosis in historical context and to provide a narrative synthesis of its evolution. Based on this narrative I will provide suggestions on how to rebuild the trust in melanoma diagnosis accuracy and in the benefit of early recognition.

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Section: The Disadvantage Of the Newly Added E Criterion Relies Onmentioning

confidence: 99%

Evolution of the Clinical, Dermoscopic and Pathologic Diagnosis of Melanoma

Kittler

2021

Dermatol Pract Concept

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Dermoscopy of Melanoma and Naevi

Jaimes,

Marghoob

2024

Rook's Textbook of Dermatology

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Dermoscopy is a non‐invasive, in vivo imaging technique known to increase the diagnostic accuracy for melanoma and improve the benign‐to‐malignant biopsy ratio by increasing the detection of melanoma while decreasing the number of naevi being biopsied. Melanocytic naevi are the primary lesions in the differential diagnosis of early melanomas. While the clinical morphology of naevi and melanoma often overlap, dermoscopy has improved the ability to discriminate between the two by visualisation of colours and structures that are otherwise not visible to the naked eye. In general, naevi tend to display a symmetrical and organised dermoscopic pattern while melanomas tend to reveal melanoma‐specific structures distributed in an asymmetrical and disorganised manner. The structures found to be associated with melanoma on non‐glabrous skin include atypical network, negative network, streaks, shiny white lines, atypical dots/globules, off‐centred blotch, blue‐white veil, regression structures, atypical vessels and peripheral tan structureless areas. Due to the unique microanatomy of other anatomical sites such as the face and glabrous skin, additional dermoscopic features have been identified that help in the detection of melanoma in these sites. This chapter provides an overview of the dermosocopic structures and patterns associated with naevi and outlines the dermoscopic structures associated with melanoma.

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