Dermatoscopy in the evaluation of cutaneous lesions in patients with familial atypical multiple-mole melanoma syndrome

Abstract

Skin cancer is currently the most common cancer type afflicting North Americans today and with an aging population the incidence is likely to increase. Certain skin cancers such as melanoma can result in significant morbidity and mortality especially if not identified and treated early. The traditional ABCDE rule (asymmetric shape, irregular borders, variation in colour, diameter >6 mm and evolution/elevation of the lesion) used to identify concerning tumours will in fact miss many early melanomas. This problem is exacerbated in patients with hereditary forms of melanoma such as Familial Atypical Multiple- Mole Melanoma (FAMMM) syndrome where multiple atypical nevi satisfying the ABCDE criteria are present and would therefore warrant biopsy. Most of these biopsies would be unnecessary and would increase the patient’s morbidity. Dermatoscopy is a clinical tool that provides a bridge between clinical and histopathologic evaluation and has proven to be helpful in triaging suspicious lesions in the general population and to be a first-line screening tool to increase the detection of early melanomas in patients with FAMMM.