Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy

• Verfasst von: Tschandl, Philipp [VerfasserIn]
• Verfasst von: Müller-Christmann, Christine [VerfasserIn]
• Verfasst von: Hänßle, Holger [VerfasserIn]
• Titel: Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy
• Titelzusatz: do melanomas and nevi already differ at baseline?
• Verf.angabe: P. Tschandl, L. Hofmann, C. Fink, H. Kittler, H.A. Haenssle
• Jahr: 2017
• Jahr des Originals: 2016
• Umfang: 6 S.
• Fussnoten: Gesehen am 07.09.2018 ; Article was first published on 29 November 2016
• Titel Quelle: Enthalten in: European Academy of Dermatology and VenereologyJournal of the European Academy of Dermatology and Venereology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1991
• Jahr Quelle: 2017
• Band/Heft Quelle: 31(2017), 6, Seite 972-977
• ISSN Quelle: 1468-3083
• DOI: doi:10.1111/jdv.14065
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1580773915

Abstract

Background: What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. Objective: To compare the grade of atypia of melanomas and nevi of the same patient at baseline. Methods: Prospective observational study using 236 dermatoscopic baseline images (59 quartets from 59 patients, each including one melanoma detected during follow-up and three nevi). Dermatologists (n = 26) were asked to assess the ‘grade of dermatoscopic atypia’ on a numerical scale and to identify the melanomas. Results: On average, each dermatologist identified 24 of 59 melanomas (40%, range: 11-37). The number of correct picks was greater for dermatologists with moderate (mean: 28) or high (mean: 28) experience compared to beginners (mean 17; P < 0.001). In three of the 59 sets, none of the 26 dermatologists identified the melanoma. The mean grade of dermatoscopic atypia was 2.5 for nevi (95% CI: 2.4-2.6) and 3.0 for melanomas (95% CI: 2.9-3.1, P < 0.001). Limitations: Rating dermatologists were informed that each quartet of images included one melanoma creating substantial deviation from a real-life situation. Conclusion: A significant proportion of melanomas detected during follow-up cannot be differentiated from nevi at baseline. This necessitates the additional inclusion of less atypical lesions for monitoring.