Follow-up of melanocytic skin lesions with digital epiluminescence microscopy: Patterns of modifications observed in early melanoma, atypical nevi, and common nevi - 05/09/11
Abstract |
Background: Digital epiluminescence microscopy (DELM) has been reported to be a useful technique for the follow-up of melanocytic nevi. One of the promises of this technique is to identify modifications over time that indicate impending or incipient malignancy and to facilitate surveillance of melanocytic skin lesions, particularly in patients with multiple clinically atypical nevi. Objective: Our purpose was to report on patterns of modifications over time observed in benign melanocytic skin lesions and melanoma. Methods: A total of 1862 sequentially recorded DELM images of melanocytic lesions from 202 patients (mean age, 36.1 years; 54.0% female patients) with multiple clinically atypical nevi were included in the analysis. The median follow-up interval was 12.6 months. Melanocytic lesions with substantial modifications over time (enlargement, changes in shape, regression, color changes or appearance of ELM structures known to be associated with melanoma) were excised and referred to histopathologic examination. Results: A total of 75 melanocytic skin lesions (4.0%) from 52 patients (mean age, 33.3 years; 63.5% female patients) showed substantial modifications over time and were excised and referred to histopathologic examination. Eight changing lesions were histologically diagnosed as early melanomas. These lesions frequently showed focal enlargement associated with a change in shape as well as appearance of ELM structures that are known to be associated with melanoma. In contrast, the majority of benign changing lesions (common and atypical nevi) showed symmetric enlargement without substantial structural ELM changes. Six of the 8 patients in whom melanoma developed were unaware of the fact that the lesion had changed over time. Conclusion: We demonstrate that follow-up of melanocytic lesions with DELM helps to identify patterns of morphologic modifications typical for early melanoma. DELM may therefore serve as a useful tool to improve the surveillance of patients with multiple atypical nevi. (J Am Acad Dermatol 2000;43:467–76.).
Le texte complet de cet article est disponible en PDF.Plan
 | Supported by a grant of the Austrian Science Fund (FWF-P11735MED) and a grant from the Max Kade Foundation Inc., New York City (to M. B.). |
| Drs Binder, Pehamberger, and Wolff have been involved in the development of the device Mole Max II, which was used in this study, and they serve as consultants for the manufacturer. |
 | Reprint requests: Harold Kittler, MD, Department of Dermatology, University of Vienna Medical School, Waehringerguertel 18-20, A-1090 Vienna, Austria. E-mail: h.kittler@akh-wien.ac.at. |
| J Am Acad Dermatol 2000;43:467–76. |
Vol 43 - N° 3
P. 467-476 - septembre 2000 Retour au numéro
Article précédent
- Preoperative assessment of melanoma thickness by ABCD score of dermatoscopy
- Paolo Carli, Vincenzo de Giorgi, Domenico Palli, Vanni Giannotti, Benvenuto Giannotti
- Fractionated radiotherapy of lentigo maligna and lentigo maligna melanoma in 64 patients
- M.H. Schmid-Wendtner, B. Brunner, B. Konz, P. Kaudewitz, C.M. Wendtner, R.U. Peter, G. Plewig, M. Volkenandt
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?