Three-Dimensional Total Body Photography, Digital Dermoscopy, and in vivo Reflectance Confocal Microscopy for Follow-Up Assessments of High-Risk Patients for Melanoma: A Prospective, Controlled Study

Abstract

Plain Language SummaryThe combination of total body photography (TBP) and digital dermoscopy (DD) for the monitoring of patients with high risk for melanoma leads to early detection of melanoma. The aim of the present study was to examine if regular monitoring of patients with high risk for melanoma with 3D-TBP, DD, and confocal microscopy (RCM) leads to a benefit in comparison to a control group (CG). The intervention group (IG) was examined with 3D-TBP at every visit. If necessary, DD and/or RCM were used for diagnosis and/or monitoring of pigmented lesions. The CG was examined clinically with dermoscopy only. A total of 600 patients (324 male and 276 female) were followed up between April 21, 2021, and January 8, 2024. Lesions (n = 166) were monitored with DD and 105 lesions were examined with RCM. The number of lesions that the dermatologists had to cut out to find a melanoma was 2.83, when RCM was used. There were more melanomas (22 vs. 1, p = 0.022) and more nevi excised in the IG (186 vs. 10, p < 0.001), among them more dysplastic nevi (137 vs. 2, p < 0.001). Out of the melanomas diagnosed in the IG, three melanomas were diagnosed with RCM directly, nine melanomas with the combination of 3D-TBP and RCM, and 10 melanomas were diagnosed clinically with dermoscopy only. The follow-up with the combination of 3D-TBP, DD and RCM led to detection of more melanomas in comparison to a CG. RCM led to a reduced NNT for melanocytic lesions.