Selection of Patients for Long-term Surveillance With Digital Dermoscopy by Assessment of Melanoma Risk Factors
2010 | journal article. A publication with affiliation to the University of Göttingen.
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Selection of Patients for Long-term Surveillance With Digital Dermoscopy by Assessment of Melanoma Risk Factors
Haenssle, H. A.; Korpas, B.; Hansen-Hagge, C.; Buhl, T.; Kaune, K. M.; Johnsen, S. & Rosenberger, A. et al. (2010)
Archives of Dermatology, 146(3) pp. 257-264. DOI: https://doi.org/10.1001/archdermatol.2009.370
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Details
- Authors
- Haenssle, Holger A.; Korpas, Bianca; Hansen-Hagge, Christian; Buhl, Timo; Kaune, Kjell M.; Johnsen, Steven; Rosenberger, Albert ; Schön, Michael P.; Emmert, Steffen
- Abstract
- Objective: To identify patients at increased melanoma risk who benefit from long-term surveillance with digital dermoscopy. Design: Prospective, nonrandomized, observational study. Setting: University-based surveillance program. Participants: Six hundred eighty-eight patients prospectively categorized into defined melanoma risk groups and followed up (mean, 44.3 months) by clinical examinations, dermoscopy, and, for atypical nevi, sequential digital dermoscopy. Main Outcome Measure: Association between patient risk factors and detection of melanomas. Results: Odds ratios from a multivariate logistic regression analysis indicated a highly increased melanoma risk for patients with familial atypical mole and multiple melanoma (FAMMM) syndrome, atypical mole syndrome (AMS), or previous melanoma. Each digitally documerited atypical lesion (range, 1-17 lesions per patient) denoted a significant 10% increase in melanoma risk. Patients with higher melanoma risk (1) showed a higher percentage of melanomas detected by digital dermoscopy (FAMMM syndrome group, 50%; AMS group, 22%), (2) more often developed multiple melanomas within shorter intervals, and (3) showed a ratio of melanoma to benign results for lesions excised because of dynamic changes of 1:15 (AMS group) or 1:4 (FAMMM syndrome group). Melanomas detected by digital dermoscopy were significantly thinner (0.41 mm in mean Breslow thickness) compared with melanomas detected by other means (0.62 mm; P=.04). Conclusions: We suggest an individualized surveillance plan, with digital dermoscopy performed at follow-up intervals of 3 months for patients with FAMMM syndrome and 6 to 12 months (depending on additional risk factors) for those with AMS. Patients with multiple common nevi and no additional risk factors had no benefit from sequential digital dermoscopy.
- Issue Date
- 2010
- Status
- published
- Publisher
- Amer Medical Assoc
- Journal
- Archives of Dermatology
- ISSN
- 0003-987X
- Language
- English