Diagnostic accuracy and safety of short-term teledermoscopic monitoring of atypical melanocytic lesions

• Background: Short-term dermoscopic monitoring (STDM) of atypical melanocytic lesions (AML) after 3.0–4.5months can be used to detect featureless melanomas without performing countless unnecessary excisions of nevi. Recently, short-term teledermoscopic monitoring (STTM) was incorporated into the STDM clinical routine at Sahlgrenska University Hospital in Gothenburg, Sweden. Follow-up images for STTM were taken by an assistant nurse with subsequent teledermoscopic assessment by a dermatologist. Objectives: The purpose of this study was to evaluate the diagnostic accuracy and safety of STTM. Methods: In this retrospective observational study, data from electronic health records of patients with teledermoscopically monitored AMLs were explored. The number of changed and excised AMLs and their histopathological diagnoses were recorded. The excised AMLs were categorized into three subgroups according to when they changed and were excised: (i) following STTM, (ii) after planned long-term follow-up or (iii) after unplanned long-term follow-up. Results: A total of 686 patients with 883 AMLs were monitored with STTM. Sixty-two AMLs (7.0%) were excised following STTM, 14 (1.6%) after planned long-term follow-up and 10 (1,1%) after unplanned long-term follow-up. Twenty-one melanomas were detected using STTM, three after planned long-term follow-up and three after unplanned long-term follow-up. All melanomas were insitu (n=20) or thin and non-ulcerated (n=7; median Breslow thickness 0.4mm, range 0.3–0.8mm). The sensitivity for the diagnosis of melanoma by means of STTM with the option of additional planned follow-up was 88.9%, and the specificity was 93.9%. The number of AMLs needed to monitor in order to detect one melanoma with the STTM routine was 32.7, and the number needed to excise was 3.2. Conclusions: STTM of AMLs was safe and allowed for high diagnostic accuracy. All detected melanomas were insitu or thin and non-ulcerated. Furthermore, a considerable number of unnecessary excisions were spared. © 2019 European Academy of Dermatology and Venereology

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)

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