Department of Dermatology, Medical University of Graz, Graz, Austria.
Institute of Physiology, Medical University of Graz, Graz, Austria.
J Dtsch Dermatol Ges. 2020 Jul;18(7):692-697. doi: 10.1111/ddg.14158. Epub 2020 Jun 29.
The incidence of melanoma is rising and prevention plays an important role. Multiple nevi as well as a medical history of melanoma are important risk factors. In affected patients, a two-step algorithm consisting of total-body photography (TBP) and sequential digital dermatoscopy (SDD) is a helpful diagnostic tool.
This was a retrospective observational study that lasted six years in order to evaluate the significance of the two-step algorithm. Cases were evaluated based on distinct dermoscopic patterns and statistical analyses were performed with the latest version of SPSS.
6020 dermoscopic images of 214 patients were included. TBP was performed at a mean interval of 16.9 months (SD ± 1.43 months), while SDD was performed every 9.9 months (SD ± 1.68 months). The number needed to excise was 4.6 and the number needed to monitor was 548. Excisions were mostly performed because dynamic changes were observed. A total of eleven melanomas were detected and had a mean tumor thickness of 0.44 mm (SD ± 0.15 mm; range 0.2-0.6 mm).
Invasive melanomas had a tumor thickness of less than 0.6 mm, thus providing evidence of an effective strategy for early melanoma detection. Excisions of benign nevi were minimized as indicated by a low number needed to excise.
黑色素瘤的发病率正在上升，预防起着重要作用。多发性痣和黑色素瘤病史是重要的危险因素。在受影响的患者中，总身体摄影（TBP）和连续数字皮肤镜检查（SDD）的两步算法是一种有用的诊断工具。
这是一项历时六年的回顾性观察研究，旨在评估两步算法的意义。根据不同的皮肤镜模式对病例进行评估，并使用最新版本的 SPSS 进行统计分析。
共纳入 214 例患者的 6020 张皮肤镜图像。TBP 的平均间隔为 16.9 个月（SD ± 1.43 个月），而 SDD 的平均间隔为 9.9 个月（SD ± 1.68 个月）。需要切除的数量为 4.6，需要监测的数量为 548。切除主要是因为观察到动态变化。共发现 11 例黑色素瘤，平均肿瘤厚度为 0.44 毫米（SD ± 0.15 毫米；范围 0.2-0.6 毫米）。
侵袭性黑色素瘤的肿瘤厚度小于 0.6 毫米，这为早期黑色素瘤检测的有效策略提供了证据。通过需要切除的数量较少，最大限度地减少了良性痣的切除。
