Dermoscopic monitoring of melanocytic skin lesions: Clinical outcome and patient compliance vary according to follow-up protocols

G. Argenziano, I. Mordente, G. Ferrara, A. Sgambato, P. Annese, I. Zalaudek

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Dermoscopic monitoring of melanocytic lesions increases the likelihood that featureless melanomas are not overlooked and minimizes the excision of benign lesions. Objective: To examine clinical outcome and patient compliance using different follow-up protocols. Methods: A retrospective analysis of 600 lesions from 405 patients (aged 6-79 years) was performed to examine patient compliance and clinical outcome in patients with multiple atypical melanocytic lesions undergoing sequential dermoscopy imaging during short-, medium- or long-term follow-up. Based on the degree of dermoscopic atypical features, patients were scheduled for short-term monitoring with follow-up after 3 months, medium-term monitoring with follow-up after 6 months or long-term monitoring with annual follow-up. Criteria leading to excision of monitored lesions differed according to the follow-up protocol. Results: In a median follow-up period of 23 months, 54 (9%) lesions were excised, revealing 12 early melanomas (occurring in 3% of monitored patients), one basal cell carcinoma and 41 melanocytic naevi. The melanoma/benign ratio of excised lesions was 1 : 3.4. Seven of 12 melanomas showed changes after two to four visits, corresponding to 8-54 months of follow-up. Patient compliance was 84% for short-term monitoring, 63% for medium-term monitoring and 30% for long-term monitoring. Conclusions: In patients with multiple naevi sequential dermoscopy imaging is a useful strategy to avoid missing melanomas while minimizing unnecessary excision of benign lesions. For better compliance, the first re-examination should be scheduled at 3 months after the baseline visit. Regular annual follow-up monitoring is also needed to detect slow-growing melanomas in which subtle changes may become apparent only over time.

Original languageEnglish
Pages (from-to)331-336
Number of pages6
JournalBritish Journal of Dermatology
Volume159
Issue number2
DOIs
Publication statusPublished - Aug 2008

Keywords

  • Imaging techniques
  • Melanoma
  • Naevi
  • Patient monitoring

ASJC Scopus subject areas

  • Dermatology

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