title: Variables predicting change in benign melanocytic nevi undergoing short-term dermoscopic imaging.
abstract: OBJECTIVE
  To determine whether certain patient demographics are associated with poorer specificity for the diagnosis of melanoma in nevi undergoing short-term sequential digital dermoscopic imaging.
  
  
  METHODS
  Retrospective cohort study performed from April 1, 1998, through May 31, 2007.
  
  
  METHODS
  Sydney Melanoma Diagnostic Centre, a tertiary referral institution.
  
  
  METHODS
  A total of 2497 benign melanocytic lesions in 1765 patients undergoing short-term sequential digital dermoscopic imaging during 2.5 to 4.5 months (42.3% male; mean [SD] age, 40 [14] years; age range, 1-86 years).
  
  
  METHODS
  Proportion of changed nevi as a function of age, sex, lesion diameter, and anatomical site.
  
  
  RESULTS
  The only variable significantly associated with nevus change was age group (P = .002). When compared with the middle-aged (aged 36-50 years) group, the odds of change were significantly increased in the child and adolescent (aged 0-18 years: odds ratio, 2.60; 95% confidence interval, 1.30-5.22), young adult (aged 19-35 years: 1.50; 1.04-2.17), and elderly (> 65 years old: 2.04; 1.04-3.99) age groups. Within the changed benign lesions, a significant association was observed between histologic subtype and age group (P = .01). The proportion of changed lesions of the banal nevi type decreased and the proportion of the dysplastic nevi type increased with age. In the elderly group, 75.9% of changed lesions were of the dysplastic nevi type compared with 35.7% in the youngest group.
  
  
  CONCLUSIONS
  A poorer specificity is observed for the diagnosis of melanoma for nevi undergoing short-term sequential digital dermoscopic imaging in children and adolescents (75.7%) and elderly patients (77.9%) compared with other patients (84.6%).
authors.affiliation: Discipline of Dermatology, Sydney Medical School, University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, 2050 Australia. scott.menzies@sswahs.nsw.gov.au
authors.forename: Scott W
authors.initials: SW
authors.lastname: Menzies
authors.forename: Mary L
authors.initials: ML
authors.lastname: Stevenson
authors.forename: Davide
authors.initials: D
authors.lastname: Altamura
authors.forename: Karen
authors.initials: K
authors.lastname: Byth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult