Moscarella E, Tion I, Zalaudek I, Lallas A, Kyrgidis A, Longo C, Lombardi M, Raucci M, Satta R, Alfano R, Argenziano G
Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy.
Unit of Dermatology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
J Eur Acad Dermatol Venereol. 2017 Feb;31(2):247-251. doi: 10.1111/jdv.13840. Epub 2016 Jul 16.
Digital dermoscopy monitoring (DDM) is an effective strategy for melanoma detection. Two methods are currently employed. Short-term follow-up (STFU) for the evaluation of single, atypical lesions to detect subtle changes over a short period of time (3-6 months). Long-term follow-up (LTFU) is recommended for patients with multiple nevi. Although a study demonstrated that STFU improves the patients' compliance for DDM, little remains known about the impact and reliability of STFU in this setting.
The aim of this retrospective, observational study was to evaluate the impact and reliability of a schedule combining STFU and LTFU in patients with multiple atypical nevi.
We searched our database for all cases of patients with multiple atypical nevi occurring between 2006 and 2014.
A total of 3823 lesions in 541 patients were dermoscopically monitored (mean number = 7 lesions per patient; median = 6 lesions; range, 2-51). In all, 264 (6.9%) lesions in 184 (34.4%) patients were excised (mean of 0.5 lesions per patient). In total, 197 (74.6%) lesions were excised at follow-up, with melanomas representing 30.5% of lesions excised after follow-up. A total of 30 (33.3%) melanomas were excised at baseline, 23 (25.6%) after STFU and 37 (41.1%) after LTFU. There was no difference in the number of in situ melanomas detected at baseline with those detected after follow-up. The mean Breslow thickness of melanomas detected at baseline was higher than those detected after STFU (P = 0.038) and LTFU (P = 0.055).
Our study confirm that digital dermoscopy follow-up is a valid management strategy for patients with multiple atypical nevi, with short-term monitoring playing an effective role also in this setting of patients.
数字皮肤镜监测（DDM）是一种有效的黑色素瘤检测策略。目前采用两种方法。短期随访（STFU）用于评估单个非典型病变，以在短时间内（3 - 6个月）检测细微变化。对于有多发性痣的患者，建议进行长期随访（LTFU）。尽管一项研究表明STFU提高了患者对DDM的依从性，但在这种情况下，关于STFU的影响和可靠性仍知之甚少。
这项回顾性观察研究的目的是评估在有多发性非典型痣的患者中，结合STFU和LTFU的方案的影响和可靠性。
我们在数据库中搜索了2006年至2014年间所有有多发性非典型痣的患者病例。
共对541例患者的3823个病变进行了皮肤镜监测（平均每位患者7个病变；中位数 = 6个病变；范围为2 - 51个）。总共，184例（34.4%）患者中的264个（6.9%）病变被切除（平均每位患者0.5个病变）。总共，197个（74.6%）病变在随访时被切除，黑色素瘤占随访后切除病变的30.5%。共有30个（33.3%）黑色素瘤在基线时被切除，23个（25.6%）在STFU后被切除，37个（41.1%）在LTFU后被切除。基线时检测到的原位黑色素瘤数量与随访后检测到的数量没有差异。基线时检测到的黑色素瘤的平均Breslow厚度高于STFU后（P = 0.038）和LTFU后（P = 0.055）检测到的黑色素瘤。
我们的研究证实，数字皮肤镜随访对于有多发性非典型痣的患者是一种有效的管理策略，短期监测在这类患者中也发挥着有效作用。
