This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (7)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Dermatologic Disorders  • Neoplasms  • Diagnosis  • Alert me on articles by topic  Social Bookmarking   What's this?

Davide Altamura, MD; Michelle Avramidis, BSc; Scott W. Menzies, MBBS, PhD

Arch Dermatol. 2008;144(4):502-506.

Objective  To determine whether 6 weeks could replace 3 months for short-term sequential digital dermoscopy imaging (ST-SDDI) of suspicious melanocytic lesions and determine the proportion of melanomas missed.

Design  Consecutive lesions (n = 2602) undergoing ST-SDDI monitored from 1859 patients were included. Half of the patients underwent 6-week monitoring followed by 3-month monitoring (range, 2.5-4.5 months) if changes were not seen. The remainder underwent 3-month monitoring only. Any change during this time led to excision. Lesions unchanged were then followed up over time.

Setting  A tertiary referral institution.

Main Outcome Measures  The proportion of changed melanomas (sensitivity) and odds ratios (ORs) for melanoma of changed lesions.

Results  Eighty-one melanomas were detected using ST-SDDI (Breslow thickness: median, in situ; maximum, 0.8 mm). Of 39 melanomas detected using ST-SDDI in the 6-week monitored lesions, 27 (69%) were detected at 6 weeks and 12 (31%) at 3 months. The OR for melanoma for a lesion changing at 6 weeks was 19 (95% confidence interval [CI], 10-35), and the overall OR for melanoma for a lesion changing during the short-term monitoring period (6 weeks to 4.5 months) was 47 (95% CI, 23-94). For lesions remaining unchanged at 3 months, 99.2% (1118 of 1127 lesions) were shown to be benign as defined by an unremarkable further follow-up. Seventy-five percent (15 of 20) of the lentigo maligna melanomas, 93% (40 of 43) of other in situ melanomas, and 96% (26 of 27) of the invasive melanomas were detected using ST-SDDI.

Conclusion  Three months remains the standard interval for ST-SDDI, where the sensitivity for the diagnosis of melanoma for changed (non–lentigo maligna) lesions is high but not 100%.

Author Affiliations: Department of Dermatology, University of L’Aquila, L’Aquila, Italy (Dr Altamura); Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia (Ms Avramidis and Dr Menzies); and Faculty of Medicine, University of Sydney, Sydney, Australia (Dr Menzies).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Early Recognition at Last
Harald Kittler
Arch Dermatol. 2008;144(4):533-534.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi
Zalaudek et al.
Arch Dermatol 2009;145:816-826.
ABSTRACT | FULL TEXT  

Early Recognition at Last
Kittler
Arch Dermatol 2008;144:533-534.
FULL TEXT