JAAD onlineBenefits 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
Section snippets
Study population
A total of 629 patients included in the surveillance program with TBP and digital dermatoscopy at the Melanoma Unit of Hospital Clinic of Barcelona, Spain, were followed up between January 1999 and December 2008.
The criteria for patient inclusion in our follow-up program include: moderate to severe atypical mole syndrome (AMS) (defined by >100 nevi and/or >10 clinically atypical according to ABCD criteria, and/or any histologically dysplastic nevi), personal and/or familial history of MM,
Results
The surveillance program cohort consisted of 618 patients with a mean age of 37 years (mean SD ± 13.3 years) at time of inclusion in the program; 45.5% were men. According to inclusion criteria, the vast majority of the patients (n = 556) had AMS and only 7.1 (n = 44) had less than 50 nevi associated to other high-risk conditions. Of the patients, 277 had a personal history of MM, including 73 with a history of multiple primary MMs, before the beginning of the study; 8 patients with giant
Discussion
Various strategies have been suggested for MM detection in patients at high risk, such as skin self-examination,12, 13 total cutaneous examination,14 and the use of TBP3, 15, 16, 17, 18, 19 and dermatoscopy.20, 21 It has been well demonstrated that clinical examination is inaccurate for the diagnosis of incipient MM22 whereas dermatoscopy has been shown to improve the diagnostic accuracy of nearly all cutaneous tumors including melanoma.20, 21, 23
During the last few years, increasing evidence
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Funding sources: The research at the melanoma unit in Barcelona is partially funded by grants 03/0019, 05/0302, and 06/0265 from Fondo de Investigaciones Sanitarias, Spain; by the CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain; by the Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) 2009 SGR (Suport a grups de recerca) 1337 of the Catalan Government, Spain; by the European Commission under the Sixth Framework Programme, contract No. LSHC-CT-2006-018702 (GenoMEL); and by the National Cancer Institute of the US National Institutes of Health (CA83115). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript.
Conflicts of interest: None declared.