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Total Body Photography and Sequential Digital Dermoscopy for Melanoma Diagnosis

  • Maria Antonietta PizzichettaEmail author
  • Ignazio Stanganelli
Chapter
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Abstract

The dermoscopic diagnosis of melanoma is difficult for some early tumors that lack the characteristic features from which a diagnosis is made. The diagnosis of these “featureless melanomas” is facilitated by monitoring over time to document any changes. Monitoring can be done with total body photography (TBP) and, for individual lesions, sequential digital dermoscopy (SDD). TBP allows the detection of both de novo melanomas and melanomas arising in association with a nevus, presenting as a change in a preexisting lesion. TBP helps in the early detection of melanomas in high-risk patients with many nevi, including atypical ones. SDD is useful for monitoring flat, atypical melanocytic lesions lacking clinical or dermoscopic features of melanoma at baseline, allowing the detection of subtle changes. In two prospective studies of high-risk patients, SDD detected 18 of the 53 melanomas or 39% of all melanomas, whereas a retrospective study of routine clinical practice found that the changes observed with SDD allowed the detection of 12 of 99 melanomas. In addition, SDD has been shown to reduce the ratio of benign moles excised for each melanoma diagnosed, thereby reducing the number needed to treat. A combination of TBP and SDD provides optimal surveillance in high-risk patients because melanomas diagnosed this way have been found to be thinner than those detected with standard clinical means. The combination of SDD with reflectance confocal microscopy is useful for the examination of equivocal lesions and lesions that change during monitoring and can help reduce the number of unnecessary excisions.

Keywords

Digital dermoscopy Sequential digital dermoscopy Total body photography Featureless melanoma Atypical nevi Early melanoma 

Notes

Acknowledgments

Valerie Matarese provided scientific editing.

References

  1. 1.
    Vestergaard ME, Macaskill P, Holt PE, et al. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159(3):669–76.PubMedGoogle Scholar
  2. 2.
    Menzies SW, Ingvar C, Crotty KA, McCarthy WH. Frequency and morphologic characteristics of invasive melanomas lacking specific surface microscopic features. Arch Dermatol. 1996;132:1178–82.CrossRefGoogle Scholar
  3. 3.
    Pizzichetta MA, Stanganelli I, Bono R, et al. Dermoscopic features of difficult melanoma. Dermatol Surg. 2007;33:91–9.PubMedGoogle Scholar
  4. 4.
    Carrera C, Marchetti MA, Dusza SW, et al. Validity and reliability of dermoscopic criteria used to differentiate nevi from melanoma: a web-based international Dermoscopy Society Study. JAMA Dermatol. 2016;152(7):798–806.CrossRefGoogle Scholar
  5. 5.
    Skvara H, Teban L, Fiebiger M, et al. Limitations of dermoscopy in the recognition of melanoma. Arch Dermatol. 2005;141:155–60.CrossRefGoogle Scholar
  6. 6.
    Malvehy J, Puig S. Follow-up of melanocytic skin lesions with digital total-body photography and digital dermoscopy: a two-step method. Clin Dermatol. 2002;20:297–304.CrossRefGoogle Scholar
  7. 7.
    Salerni G, Carrera C, Lovatto L, et al. Benefit of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma. J Am Acad Dermatol. 2012;67(1):e17–27.CrossRefGoogle Scholar
  8. 8.
    Feit NE, Dusza SW, Marghoob AA. Melanomas detected with the aid of total cutaneous photography. Br J Dermatol. 2004;150:706–14.CrossRefGoogle Scholar
  9. 9.
    Banky JP, Kelly JW, English DR, et al. Incidence of new and changed nevi and melanomas detected using baseline images and dermoscopy in patients at high risk for melanoma. Arch Dermatol. 2005;141:998–1006.CrossRefGoogle Scholar
  10. 10.
    Truong A, Strazzulla L, March J, et al. Reduction in nevus biopsies in patients monitored by total body photography. J Am Acad Dermatol. 2016;75:135–43.CrossRefGoogle Scholar
  11. 11.
    Salerni G, Terán T, Puig S, et al. Meta-analysis of digital dermoscopy follow-up of melanocytic skin lesions: a study on behalf of the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2013;27(7):805–14.CrossRefGoogle Scholar
  12. 12.
    Argenziano G, Mordente I, Ferrara G, et al. Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocols. Br J Dermatol. 2008;159:331–6.CrossRefGoogle Scholar
  13. 13.
    Bowling J, Argenziano G, Azenha A, et al. Dermoscopy key points: recommendations from the International Dermoscopy Society. Dermatology. 2007;214:3–5.CrossRefGoogle Scholar
  14. 14.
    Haenssle HA, Krueger U, Vente C, et al. Results from an observational trial: digital epiluminescence microscopy follow-up of atypical nevi increases the sensitivity and the chance of success of conventional dermoscopy in detecting melanoma. J Invest Dermatol. 2006;126(5):980–5.CrossRefGoogle Scholar
  15. 15.
    Altamura D, Avramidis M, Menzies SW. Assessment of the optimal interval for and sensitivity of short-term sequential digital dermoscopy monitoring for the diagnosis of melanoma. Arch Dermatol. 2008;144(4):502–6.CrossRefGoogle Scholar
  16. 16.
    Robinson JK, Nickoloff BJ. Digital epiluminescence microscopy monitoring of high-risk patients. Arch Dermatol. 2004;140(1):49–56.PubMedGoogle Scholar
  17. 17.
    Kittler H, Guitera P, Riedl E, et al. Identification of clinically featureless incipient melanoma using sequential dermoscopy imaging. Arch Dermatol. 2006;142:1113–9.CrossRefGoogle Scholar
  18. 18.
    Terushkin V, Dusza SW, Scope A, et al. Changes observed in slow-growing melanomas during long-term dermoscopic monitoring. Br J Dermatol. 2012;166(6):1213–20.CrossRefGoogle Scholar
  19. 19.
    Moloney FJ, Guitera P, Coates E, et al. Detection of primary melanoma in individuals at extreme high risk: a prospective 5-year follow-up study. JAMA Dermatol. 2014;150(8):819–27.CrossRefGoogle Scholar
  20. 20.
    Salerni G, Teran R, Alonso C, et al. The role of dermoscopy and digital dermoscopy follow-up in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas. Dermatol Pract Concept. 2014;4(4):39–46.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Tromme I, Sacrè L, Hammouch F, et al. Availability of digital dermoscopy in daily practice dramatically reduces the number of excised melanocytic lesions: results from an observational study. Br J Dermatol. 2012;167:778–86.CrossRefGoogle Scholar
  22. 22.
    Secker LJ, Bergaman W, Kukutsch NA. Total body photography as an aid to skin self-examination: a patient’s perspective. Acta Derm Venereol. 2016;96(2):186–90.CrossRefGoogle Scholar
  23. 23.
    Pagliarello C, Stanganelli I, Fabrizi G, Feliciani C, Di Nuzzo S. Digital dermoscopy monitoring: is it time to define a quality standard? Acta Derm Venereol. 2017;97(7):864–5.CrossRefGoogle Scholar
  24. 24.
    Finnane A, Curiel-Lewandrowski C, Wimberley G, et al. International Society of Digital Imaging of the Skin (ISDIS) for the International Skin Imaging Collaboration (ISIC). Proposed technical guidelines for the acquisition of clinical images of skin-related conditions. JAMA Dermatol. 2017;153(5):453–7.CrossRefGoogle Scholar
  25. 25.
    Watts CG, Cust AE, Menzies SW, et al. Cost-effectiveness of skin surveillance through a specialized clinic for patients at high risk of melanoma. J Clin Oncol. 2017;35(1):63–71.CrossRefGoogle Scholar
  26. 26.
    Pellacani G, Witkowski A, Cesinaro AM, et al. Cost-benefit of reflectance confocal microscopy in the diagnostic performance of melanoma. J Eur Acad Dermatol Venereol. 2016;30(3):413–9.CrossRefGoogle Scholar
  27. 27.
    Farnetani F, Scope A, Braun RP, et al. Skin cancer diagnosis with reflectance confocal microscopy: reproducibility of feature recognition and accuracy of diagnosis. JAMA Dermatol. 2015;151(10):1075–80.CrossRefGoogle Scholar
  28. 28.
    Pellacani G, De Pace B, Reggiani C, et al. Distinct melanoma types based on reflectance confocal microscopy. Exp Dermatol. 2014;23(6):414–8.CrossRefGoogle Scholar
  29. 29.
    Stanganelli I, Longo C, Mazzoni L, et al. Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy. Br J Dermatol. 2015;172:65–371.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Maria Antonietta Pizzichetta
    • 1
    • 2
    Email author
  • Ignazio Stanganelli
    • 3
    • 4
  1. 1.Dermatologic ClinicUniversity of TriesteTriesteItaly
  2. 2.Department of Medical OncologyCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
  3. 3.Skin Cancer Unit, IRCCS Istituto Scientifico Romagnolo per la Cura e lo Studio dei TumoriMeldolaItaly
  4. 4.Department of DermatologyUniversity of ParmaParmaItaly

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