Compliance with serial dermoscopic monitoring: An academic perspective.
BACKGROUND
For even seasoned practitioners, early melanomas can be difficult to distinguish from melanocytic nevi. Although serial digital dermoscopy is considered by many to be the gold standard for monitoring patients at high risk, poor compliance can seriously alter efficacy. In 2014, a concerning compliance rate of 25% was reported from a single, private clinic. Information is currently limited regarding the determinants of compliance and whether patients at high risk return at an acceptable rate.


OBJECTIVE
We sought to determine the compliance rate within the pigmented lesions clinic at our academic institution and identify demographic variables that may influence adherence.


METHODS
A retrospective review was conducted using 120 patient charts.


RESULTS
An overall compliance rate of 87.5% was observed with 63.3% of patients returning within 1 month of the recommended interval. The most notable risk factor for noncompliance was patient age between 20 and 29 years. Factors promoting adherence include a personal history of melanoma, greater than 5 serially monitored nevi, and a personal history of atypical nevi.


CONCLUSIONS
The external validity is limited and the sample size is small.


CONCLUSIONS
These findings contradict concerns that adherence to serial monitoring is unacceptably poor and demonstrate that compliance is highest for patients with the greatest inherent risk.
Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
Lauren M
LM
Madigan
Michigan State University College of Osteopathic Medicine, East Lansing, Michigan.
German
G
Treyger
Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. Electronic address: lkohen1@hfhs.org.
Laurie L
LL
Kohen
D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D046169:Dermoscopy; D004416:Dysplastic Nevus Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008824:Michigan; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000473:pathology; D009506:Nevus / Q000000981:diagnostic imaging* / Q000473:pathology; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010781:Photography; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
compliance; dermoscopy; digital dermoscopy; melanoma; nevi; serial dermoscopy