title: Changes observed in slow-growing melanomas during long-term dermoscopic monitoring.
abstract: BACKGROUND
  Melanomas vary in growth rate from rapidly developing nodular melanomas to slow-growing melanomas (SGM) that hardly change over years.
  
  
  OBJECTIVE
  To evaluate longitudinal changes in dermoscopic findings of SGM.
  
  
  METHODS
  We retrospectively analysed a dermoscopic image dataset from 15 pigmented lesion clinics, of SGM that were followed sequentially by digital dermoscopy for at least 1 year. We evaluated baseline and follow-up images for changes in global pattern, organization, colours, structure and size.
  
  
  RESULTS
  Our series consisted of 92 SGM. On follow-up, these melanomas developed the following dermoscopic findings: more homogeneous and less reticular global dermoscopic pattern; more frequent disorganization of pattern (baseline, 67% vs. follow-up, 79%); decreased prominence of light brown colour, increased prominence of dark brown colour, and increased frequency of the colours red, white, grey, blue and black (baseline: 29%, 3%, 18%, 6% and 33% vs. follow-up: 41%, 10%, 31%, 13% and 45%, respectively); decrease in prominence of dermoscopic structure of pigmented network, with a concomitant increase in prominence of structureless areas; and increased prominence or new appearance of melanoma-specific dermoscopic structures, including negative network, blue-white structures and blotches. The majority of lesions (75%) remained the same size or grew by < 2 mm in diameter. An increase in lesion size was associated with change in the total number of colours and structures (χ(2) = 14·3, P = 0·027) at follow-up.
  
  
  CONCLUSIONS
  While their diameter changed minimally over time, most SGM became more disorganized, revealed loss of network in favour of structureless areas, and developed new colours.
authors.affiliation: Dermatology Service, Memorial Sloan-Kettering Cancer Center, 160 East 53rd Street, New York, NY 10022, USA.
authors.forename: V
authors.initials: V
authors.lastname: Terushkin
authors.forename: S W
authors.initials: SW
authors.lastname: Dusza
authors.forename: A
authors.initials: A
authors.lastname: Scope
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
authors.forename: P
authors.initials: P
authors.lastname: Bahadoran
authors.forename: L
authors.initials: L
authors.lastname: Cowell
authors.forename: V
authors.initials: V
authors.lastname: De Giorgi
authors.forename: G
authors.initials: G
authors.lastname: Ferrara
authors.forename: H
authors.initials: H
authors.lastname: Kittler
authors.forename: J
authors.initials: J
authors.lastname: Malvehy
authors.forename: S
authors.initials: S
authors.lastname: Menzies
authors.forename: D
authors.initials: D
authors.lastname: Piccolo
authors.forename: S
authors.initials: S
authors.lastname: Puig
authors.forename: P
authors.initials: P
authors.lastname: Rubegni
authors.forename: I
authors.initials: I
authors.lastname: Stanganelli
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
authors.forename: A A
authors.initials: AA
authors.lastname: Marghoob
mesh_terms: D000328:Adult; D046169:Dermoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*