title: Impact of dermoscopy on the management of high-risk patients from melanoma families: a prospective study.
abstract: Few studies have investigated the impact of dermoscopy on the management of relatives from melanoma families. The objective of this study was to assess the impact of dermoscopy on clinical diagnosis and management decisions in high-risk familial melanoma patients. In a prospective study 132 consecutive patients were recruited from the pigmented lesions clinic of a tertiary reference centre for familial melanoma. Dermatologists expert in dermoscopy identified 49 suspicious pigmented lesions and recorded pre- and post-dermoscopy diagnoses and management decisions. Dermoscopy was performed in 37% of the patients. Two melanomas were identified. Dermoscopy did not influence sensitivity (1.0), but resulted in 42% fewer excisions, increasing specificity from 0.53 to 0.74 (p = 0.031). Dermoscopy resulted in a large reduction in the number of unnecessary excisions. These results suggest that the main effect of dermoscopy in clinical practice for this high risk population is a significant increase in specificity, rather than sensitivity.
authors.affiliation: Department of Dermatology, Leiden University Medical Center, The Netherlands. j.i.van_der_rhee@lumc.nl
authors.forename: Jasper I
authors.initials: JI
authors.lastname: van der Rhee
authors.forename: Wilma
authors.initials: W
authors.lastname: Bergman
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Kukutsch
mesh_terms: D001706:Biopsy; D046169:Dermoscopy; D004416:Dysplastic Nevus Syndrome / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D019942:Genes, p16; D020022:Genetic Predisposition to Disease; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D009154:Mutation; D009426:Netherlands; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D010375:Pedigree; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D019564:Unnecessary Procedures