Follow-up Of Melanocytic Lesions Research Articles

The Status of Dermoscopy in Chile: First National Study in Dermatologists.

Scientific evidence supports dermoscopy as an essential tool in dermatological diagnosis. The objective is to know the factors that influence its use in Chilean dermatologists. Analytical cross-sectional study. An adapted version of the survey was submitted from the pan-European study by Forsea et al to members of the Chilean Society of Dermatology, between September and December 2020. Analysis using descriptive statistics and multivariate analysis with ordinal logistic regression looking for factors associated with greater use of. One hundred and ninety-eight responses, mean age 46.3 years and 14.6 years on average practicing as dermatologists. 61.6% trained in dermoscopy during their residency. 98% use a dermatoscope. More than 80% consider dermoscopy useful for the diagnosis of melanomas, follow-up of melanocytic lesions, and diagnosis of pigmented and non-pigmented tumors. Between 50% and 70% consider it useful for monitoring non-melanocytic lesions, nail and hair pathologies. Greater confidence when evaluating pigmented and non-pigmented tumors and capillary pathology. Adjusting for age, sex, confidence, and education, participation in teaching was associated with greater use of dermoscopy in non-pigmented and pigmented tumors, and capillary pathology. Percentage of participation in the survey and training in dermoscopy higher than in the reference study, recognizing the usefulness of dermoscopy for the diagnosis and follow-up of tumor pathologies. Participating in teaching is a strong independent factor that is associated with a greater use of dermoscopy in Chile. Dermoscopy is positioned as a tool widely used by Chilean dermatologists in their daily practice.

Total body mapping in the follow-up of melanocytic lesions: recommendations of the Brazilian Society of Dermatology

Total body mapping comprises photographic documentation of the entire body surface followed by digital dermatoscopy of selected melanocytic lesions, aiming to compare their evolution over time and identify new lesions. As this is an exam based on comparative analysis of serial dermoscopic body images, standardization of the technique for performing total body mapping is essential. Prepared by specialists from the Brazilian Society of Dermatology, using the modified Delphi method, this article provides recommendations for carrying out total body mapping in Brazil, regarding its indications, technical aspects, and the issuing of the report.

Profile of the use of dermoscopy among dermatologists in Brazil (2018)

BackgroundDermoscopy increases the diagnostic accuracy in dermatology. The aspects related to training, usage profile, or perceptions of usefulness of dermoscopy among dermatologists in Brazil have not been described. ObjectivesTo evaluate the profile of the use of dermoscopy and the perception of the impact of the technique on clinical practice. MethodsThe Brazilian Society of Dermatology invited all members to complete an online form with 20 items regarding demographic data, dermatological assistance, use of dermoscopy, and perceptions of the impact of the technique on clinical practice. The proportions between the categories were compared by analysis of residuals in contingency tables, and p-values < 0.01 were considered significant. ResultsThe answers from 815 associates (9.1% of those invited to participate) were assessed, 84% of whom were female, and 71% of whom were younger than 50 years of age. The use of dermoscopy was reported in the daily practice of 98% of dermatologists: 88% reported using it more than once a day. Polarized light dermoscopy was the most used method (83%) and pattern analysis was the most used algorithm (63%). The diagnosis and follow-up of melanocytic lesions was identified as the main use of the technique, while the benefit for the diagnosis of inflammatory lesions was acknowledged by less than half of the sample (42%). Study limitationsThis was a non-randomized study. ConclusionDermoscopy is incorporated into the clinical practice of almost all Brazilian dermatologists, and it is recognized for increasing diagnostic certainty in different contexts, especially for pigmented lesions.

Follow-up of melanocytic lesions with use of dermoscopy (literature review)

Regular follow-up is the most important preventive measure in patients with high risk for the development of melanoma. Particular attention is required for patients with dysplastic nevus syndrome, in which numerous lesions must be differentiated from malignant melanoma. General principles of monitoring of clinically atypical melanocytic lesions with the use of dermoscopy and indications for a diagnostic biopsy are discussed in the article.

Stellenwert der Dermatoskopie in Deutschland - Ergebnisse aus der Pan-Euro-Dermoscopy-Querschnittsstudie.

ZusammenfassungHintergrundErhebung des aktuellen Stellenwertes der Dermatoskopie in Deutschland.MethodikIm Rahmen einer Pan‐Europäischen, internetbasierten Studie (n = 7480) der International Dermoscopy Society beantworteten 880 Dermatologinnen und Dermatologen aus Deutschland Fragen zu Ausbildungsstand, Anwendung und empfundenem Nutzen der Dermatoskopie.ErgebnisseVon den Studienteilnehmern arbeiteten 762 (86,6 %) in der vertragsärztlichen Versorgung und 98,4 % benutzten ein Dermatoskop im klinischen Alltag. Rund 93 % (n = 814) gaben mehr als fünf Jahre Erfahrung in der Anwendung der Dermatoskopie an. Die dermatoskopische Untersuchung sahen 93,6 % (n = 824) als hilfreich bei der Melanomdiagnose, 92,4 % (n = 813) bei pigmentierten Hauttumoren, 88,6 % (n = 780) bei der Verlaufskontrolle melanozytärer Läsionen, 71,4 % (n = 628) bei nicht‐pigmentierten Hauttumoren, 52,7 % (n = 464) bei der Verlaufskontrolle nicht‐melanozytärer Läsionen und 28,5 % (n = 251) bei entzündlichen Hautläsionen. Durch die Dermatoskopie empfanden 86,5 % (n = 761) der Teilnehmer die Anzahl der diagnostizierten Melanome im Vergleich zum bloßen Auge erhöht und 77,7 % (n = 684) die Anzahl unnötiger Exzisionen benigner Läsionen verringert. Studienteilnehmer mit persönlich empfundener verbesserter Melanomdiagnose durch die Dermatoskopie waren signifikant i) jünger, ii) kürzer in der Dermatologie beschäftigt, iii) seltener an einer Universitätsklinik beschäftigt, iv) häufiger in einer gesetzlichen Versorgungspraxis beschäftigt und v) häufiger während der Facharztweiterbildung in der Dermatoskopie ausgebildet worden.SchlussfolgerungenDiese Erkenntnisse sollten in der zukünftigen Aus‐ und Weiterbildung zur Verbesserung der dermatoonkologischen Versorgung sowie zur Erweiterung des dermatoskopischen Diagnosespektrums im Bereich entzündlichen Dermatosen gezielt genutzt werden.

The status of dermoscopy in Germany - results of the cross-sectional Pan-Euro-Dermoscopy Study.

Survey on the current status of dermoscopy in Germany. In the context of a pan-European internet-based study (n=7,480) conducted by the International Dermoscopy Society, 880 German dermatologists were asked to answer questions with respect to their level of training as well as their use and perceived benefit of dermoscopy. Seven hundred and sixty-two (86.6%) participants practiced dermatology in a publicly funded health care setting; 98.4% used a dermoscope in routine clinical practice. About 93% (n=814) stated to have had more than five years of experience in the use of dermoscopy. Dermoscopy was considered useful in the diagnosis of melanoma by 93.6% (n=824); for pigmented skin tumors, by 92.4% (n=813); in the follow-up of melanocytic lesions, by 88.6% (n=780); for non-pigmented lesions, by 71.4% (n=628), in the follow-up of non-melanocytic lesions, by 52.7% (n=464); and for inflammatory skin lesions, by 28.5% (n=251). Overall, 86.5% (n=761) of participants felt that - compared to naked-eye examination - dermoscopy increased the number of melanomas diagnosed; 77,7% (n=684) considered the number of unnecessary excisions of benign lesions to be decreased. Participants who personally felt that dermoscopy improved their ability to diagnose melanoma were significantly i) younger, ii) had been practicing dermatology for a shorter period of time, iii) were less commonly employed by an university-affiliated dermatology department, iv) were more frequently working in an office-based public health care setting, and v) had more frequently been trained in dermoscopy during their dermatology residency. The findings presented herein ought to be integrated into future residency and continuing medical education programs with the challenge to improve dermato-oncological care and to expand the diagnostic spectrum of dermoscopy to include inflammatory skin diseases.

Dermoscopy: distinguishing malignant tumors from benign

Dermoscopy has dramatically developed, becoming a well-established routine technique in many countries in the mid-1980s. Dermoscopy allows physicians to observe structures and colors otherwise not visible to unaided eyes, increasing melanoma diagnostic accuracy by up to 35%. Moreover, dermoscopy allows for increases in the number of diagnosed and excised melanomas together with a reduction in the number of unnecessary excisions. New data are continuously acquired mostly on melanoma diagnosis, follow-up of melanocytic lesions and nevogenesis. Short-term 3-month follow-up is the optimum time interval for identifying minimal changes in featureless melanomas. Nevertheless, long-term follow-up is similarly useful for the recognition of changes in melanomas with very low rates of growth. In the last few years a huge number of publications on dermoscopy have been published. The aim of this review is to summarize the most important recent advances in dermoscopy.

Advances in dermoscopy for detecting melanocytic lesions

Over the last 30 years dermatological approaches to diagnosis and management of melanocytic lesions have been revolutionized by the introduction of dermoscopy. Continuous improvements are being made in applying the technique, mostly in melanoma diagnosis, follow-up of melanocytic lesions and nevogenesis. Identification of new dermoscopic criteria, such as the dermoscopic island and the blue-black color for thin and nodular melanoma, respectively, further add two new weapons in the dermoscopical armamentarium for diagnosis of otherwise featureless melanoma. Recent advances show that short-term, 3-month, follow-up is the optimum time interval to identify minimal changes in initially featureless melanomas. Nevertheless, long-term follow-up is still useful for the recognition of changes in melanomas with a very low-rate of growth. Dermoscopy greatly improves diagnosis and early excision of melanomas and reduces the number of unnecessary excisions.

Follow-up of melanocytic skin lesions with digital epiluminescence microscopy: Patterns of modifications observed in early melanoma, atypical nevi, and common nevi

Background: Digital epiluminescence microscopy (DELM) has been reported to be a useful technique for the follow-up of melanocytic nevi. One of the promises of this technique is to identify modifications over time that indicate impending or incipient malignancy and to facilitate surveillance of melanocytic skin lesions, particularly in patients with multiple clinically atypical nevi. Objective: Our purpose was to report on patterns of modifications over time observed in benign melanocytic skin lesions and melanoma. Methods: A total of 1862 sequentially recorded DELM images of melanocytic lesions from 202 patients (mean age, 36.1 years; 54.0% female patients) with multiple clinically atypical nevi were included in the analysis. The median follow-up interval was 12.6 months. Melanocytic lesions with substantial modifications over time (enlargement, changes in shape, regression, color changes or appearance of ELM structures known to be associated with melanoma) were excised and referred to histopathologic examination. Results: A total of 75 melanocytic skin lesions (4.0%) from 52 patients (mean age, 33.3 years; 63.5% female patients) showed substantial modifications over time and were excised and referred to histopathologic examination. Eight changing lesions were histologically diagnosed as early melanomas. These lesions frequently showed focal enlargement associated with a change in shape as well as appearance of ELM structures that are known to be associated with melanoma. In contrast, the majority of benign changing lesions (common and atypical nevi) showed symmetric enlargement without substantial structural ELM changes. Six of the 8 patients in whom melanoma developed were unaware of the fact that the lesion had changed over time. Conclusion: We demonstrate that follow-up of melanocytic lesions with DELM helps to identify patterns of morphologic modifications typical for early melanoma. DELM may therefore serve as a useful tool to improve the surveillance of patients with multiple atypical nevi. (J Am Acad Dermatol 2000;43:467–76.).