Melanomas detected with the aid of total cutaneous photography Journal Article

Authors: Feit, N. E.; Dusza, S. W.; Marghoob, A. A.
Article Title: Melanomas detected with the aid of total cutaneous photography
Abstract: Background: Early detection of melanoma results in excision of thinner melanomas, which are associated with better prognosis. Total cutaneous photography provides a temporal comparison of lesions, which allows clinicians and patients to recognize new and subtly changing lesions. Objectives: We examined the utility of total cutaneous photography in detecting melanoma, identified the reason for biopsy of suspicious lesions and determined who detected new melanomas, the physician on follow-up examination or the patient on self-examination. Patients/methods: The charts of the 576 patients in the total cutaneous photography database were reviewed. Twelve patients were identified who had melanoma diagnosed with photographic assistance. Baseline and prebiopsy photographs, dermatology clinic notes (115 patient visits) and pathology reports for each biopsied lesion were reviewed. Histological diagnosis, cause for biopsy, and whether the lesion was detected by the patient or physician, was recorded for each of the biopsied lesions. Also noted were all the lesions that concerned patients, the cause for concern, and whether these lesions were biopsied. Results: A total of 93 lesions were biopsied in these patients. Twenty-seven (35%) of 77 melanocytic lesions were histologically diagnosed as melanoma. The thickest melanoma found measured 1.1 mm, indicating a favourable prognosis in our patients. Seventy-four per cent of the melanomas were biopsied due to changes from baseline and 19% were biopsied because they were new lesions. The changes noted were subtle and the lesions that proved to be melanoma did not satisfy the classical clinical criteria for melanoma. Eight (30%) of the melanomas were identified by patients on skin self-examination. Twenty-six per cent of the lesions that concerned patients were not biopsied after evaluation by a physician. Conclusions: We found that photographically assisted follow-up helped detect new and subtly changing melanomas, which did not satisfy the classical clinical features of melanoma. In addition, photographically assisted follow-up helped detect nonmelanoma skin cancers. Patient skin self-examination proved to be valuable, in that it complemented physician follow-up examination in detecting melanomas. Photographic follow-up was also valuable in avoiding unnecessary biopsy in suspicious, but stable lesions. Total cutaneous photography therefore may be an effective way to increase the sensitivity and specificity for detecting melanoma.
Keywords: adult; clinical article; controlled study; human tissue; aged; middle aged; retrospective studies; histopathology; carcinoma, squamous cell; follow up; cancer diagnosis; family health; melanoma; skin biopsy; skin neoplasms; tumor biopsy; biopsy; pigmentation; evaluation; nevus, pigmented; physician; photography; keratinocytes; carcinoma, basal cell; self examination; self-examination; pigmented lesions; total cutaneous photography; naevus; humans; human; male; female; priority journal; article
Journal Title: British Journal of Dermatology
Volume: 150
Issue: 4
ISSN: 0007-0963
Publisher: Blackwell Publishing  
Date Published: 2004-04-01
Start Page: 706
End Page: 714
Language: English
DOI: 10.1111/j.0007-0963.2004.05892.x
PROVIDER: scopus
PUBMED: 15099367
Notes: Br. J. Dermatol. -- Cited By (since 1996):58 -- Export Date: 16 June 2014 -- CODEN: BJDEA -- Source: Scopus
Citation Impact
MSK Authors
  1. Stephen Dusza
    246 Dusza
  2. Neal Evan Feit
    1 Feit
  3. Ashfaq A Marghoob
    500 Marghoob