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Dermatoscopic surveillance yielded similar melanoma detection capabilities as total-body photography

The combined use of total-body photography and digital dermatoscopy — named the “two-step method of digital follow-up” — allowed the detection of incipient melanoma as a result of dermatoscopic or macroscopic changes during follow-up in a recent study.

Researchers conducted the trial to assess dermatoscopic features and dynamic changes leading to excision of melanocytic lesions from 618 patients at high risk for melanoma who had been monitored from 1999 to 2008.

The analysis included 1,152 lesions excised during the surveillance. Of 779 lesions that were previously recorded, 728 were removed because of dermatoscopic changes during follow-up and 51 were removed despite demonstrating no significant change.

The remaining 373 lesions were new or had not been detected using previous total-body photography.

Susana Puig, MD, PhD

Among the 98 melanomas detected, 60 were from monitored lesions, of which 26.3% were misclassified as benign; and 38 were from the new lesion group, where 38.3% were misclassified as benign.

Asymmetric enlargement was detected in nearly 60% of the lesions. Focal changes in structure occurred in 27%, and focal changes in pigmentation occurred in 17%. The focal changes were seen more frequently in melanomas than in nevi (both P<.001).

“The two-step method of digital follow-up allows not only the detection of macroscopic changes and the occurrence of new lesions not previously registered, but also the detection of dermatoscopic changes over time,” Susana Puig, MD, PhD, Melanoma Unit, Hospital Clinic of Barcelona, told Healio.com. “Melanomas detected by dermatoscopic changes were remarkably similar to those detected in total-body photography in terms of histologic and dermatoscopic characteristics Almost 40% of melanomas diagnosed in individuals at high risk corresponded to lesions that were not under dermatoscopic surveillance.”