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Medline ® Abstract for Reference 79

of 'Atypical (dysplastic) nevi'

79
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Selection of patients for long-term surveillance with digital dermoscopy by assessment of melanoma risk factors.
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Haenssle HA, Korpas B, Hansen-Hagge C, Buhl T, Kaune KM, Johnsen S, Rosenberger A, Schön MP, Emmert S
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Arch Dermatol. 2010;146(3):257.
 
OBJECTIVE: To identify patients at increased melanoma risk who benefit from long-term surveillance with digital dermoscopy.
DESIGN: Prospective, nonrandomized, observational study.
SETTING: University-based surveillance program.
PARTICIPANTS: Six hundred eighty-eight patients prospectively categorized into defined melanoma risk groups and followed up (mean, 44.3 months) by clinical examinations, dermoscopy, and, for atypical nevi, sequential digital dermoscopy.
MAIN OUTCOME MEASURE: Association between patient risk factors and detection of melanomas.
RESULTS: Odds ratios from a multivariate logistic regression analysis indicated a highly increased melanoma risk for patients with familial atypical mole and multiple melanoma (FAMMM) syndrome, atypical mole syndrome (AMS), or previous melanoma. Each digitally documented atypical lesion (range, 1-17 lesions per patient) denoted a significant 10% increase in melanoma risk. Patients with higher melanoma risk (1) showed a higher percentage of melanomas detected by digital dermoscopy (FAMMM syndrome group, 50%; AMS group, 22%), (2) more often developed multiple melanomas within shorter intervals, and (3) showed a ratio of melanoma to benign results for lesions excised because of dynamic changes of 1:15 (AMS group) or 1:4 (FAMMM syndrome group). Melanomas detected by digital dermoscopy were significantly thinner (0.41 mm in mean Breslow thickness) compared with melanomas detected by other means (0.62 mm; P = .04).
CONCLUSIONS: We suggest an individualized surveillance plan, with digital dermoscopy performed at follow-up intervals of 3 months for patients with FAMMM syndrome and 6 to 12 months (depending on additional risk factors) for those with AMS. Patients with multiple common nevi and no additional risk factors had no benefit from sequential digital dermoscopy.
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Departments of Dermatology and Venereology, Georg-August-University Goettingen, Von-Siebold-Strasse 3, Goettingen, Germany. h.haenssle@med.uni-goettingen.de
PMID