Comparative analysis of total body and dermatoscopic photographic monitoring of nevi in similar patient populations at risk for cutaneous melanoma.
BACKGROUND
Our previous experience monitoring nevi in high-risk patients using serial digital epiluminescence microscopy (DELM) photography achieved low biopsy rates but was limited by melanomas presenting as new lesions or arising from nevi that had not been photographed.


OBJECTIVE
To determine whether biopsy rates, efficiency of melanoma detection, and melanoma origin (de novo vs nevus derived) differed in a similar patient population monitored using total body (TB) photography.


METHODS
One thousand seventy-six patients (including 187 from a prior cohort) underwent TB photography and were monitored using photographs obtained at the initial visit. Risk factors and median monitoring periods for these patients were comparable with those of patients previously monitored using DELM photography.


RESULTS
Two hundred seventy-five biopsies were performed in 467 patients on follow-up visits. Of 12 melanomas detected on follow-up, five were invasive, five presented as changing lesions and two as new lesions, nine arose de novo, and the remainder were nevus derived.


CONCLUSIONS
In our experience with both approaches, monitoring patients at risk for melanoma using TB photography was associated with lower biopsy rates and lower nevus-to-melanoma ratios than using DELM and facilitated detection of new and changing lesions. In both cohorts, the majority of melanomas detected on follow-up arose de novo.
Goodson
Agnessa Gadeliya
AG
Department of Dermatology, University of Utah, Salt Lake City, Utah, USA.
Florell
Scott R
SR
Hyde
Mark
M
Bowen
Glen M
GM
Grossman
Douglas
D
D001706:Biopsy; D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008545:Melanoma / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009506:Nevus / Q000473:pathology*; D010781:Photography / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology*