Digital dermoscopic monitoring of atypical nevi in patients at risk for melanoma.
BACKGROUND
Atypical nevi are a common risk factor for melanoma.


OBJECTIVE
The objective was to determine the utility of monitoring dermoscopic photographs of atypical nevi in a high-risk population.


METHODS
Over a 4.5-year period, digital dermoscopic photographs were taken of clinically atypical nevi at initial and follow-up visits, such that side-by-side comparisons could be made.


RESULTS
A total of 5,945 lesions were monitored in 297 patients over 3 to 52 months (median, 22 months), and 324 lesions were biopsied. Photographic (dermoscopic) changes were noted in 96 of 5,945 (1.6%) lesions, which included 64 dysplastic nevi (67%), 25 common nevi (26%), and 1 melanoma (1.0%). Of 6 melanomas biopsied during the follow-up period, only 1 was detected by dermoscopic photographic change at follow-up.


CONCLUSIONS
Most clinically atypical melanocytic nevi are stable over time, and lesions exhibiting dermoscopic changes are most likely to be dysplastic nevi. Although dermoscopy is a useful tool for clinical examination, the sensitivity of dermoscopic monitoring is limited by melanomas that may arise in normal skin or in clinically benign nevi that were not initially photographed.
Fuller
Stanley R
SR
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA.
Bowen
Glen M
GM
Tanner
Ben
B
Florell
Scott R
SR
Grossman
Douglas
D
D046169:Dermoscopy / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000473:pathology; D011237:Predictive Value of Tests; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology