Indications for Digital Monitoring of Patients With Multiple Nevi: Recommendations from the International Dermoscopy Society

Teresa Russo; Vincenzo Piccolo; Elvira Moscarella; Philipp Tschandl; Harald Kittler; John Paoli; Aimilios Lallas; Ralph P Braun; Luc Thomas; H Peter Soyer; Josep Malvehy; Susana Puig; Ashfaq Marghoob; Alon Scope; Andreas Blum; Allan C Halpern; Horacio Cabo; Scott Menzies; Wilhem Stolz; Masaru Tanaka; Harold Rabinovitz; Rainer Hofmann-Wellenhof; Renato Marchiori Bakos; Iris Zalaudek; Giovanni Pellacani; Anna Varela Veiga; Laura Rosende Maceiras; Cristina de las Heras-Sotos; Giuseppe Argenziano

doi:10.5826/dpc.1204a182

Indications for Digital Monitoring of Patients With Multiple Nevi: Recommendations from the International Dermoscopy Society

Authors

Teresa Russo Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
Vincenzo Piccolo Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
Elvira Moscarella Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
Philipp Tschandl Department of Dermatology, Medical University of Vienna, Austria
Harald Kittler Department of Dermatology, Medical University of Vienna, Austria
John Paoli Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Aimilios Lallas First Department of Dermatology, Aristotle University, Thessaloniki, Greece
Ralph P Braun Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
Luc Thomas Department of Dermatology, Lyon-1 University, and Cancer research center Lyon France
H Peter Soyer The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Australia
Josep Malvehy Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona & IDIBAPS & CIBERER, Barcelona, Spain
Susana Puig Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona & IDIBAPS & CIBERER, Barcelona, Spain
Ashfaq Marghoob
Alon Scope Memorial Sloan Kettering Cancer Center, Hauppauge, New York
Andreas Blum Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
Allan C Halpern Memorial Sloan Kettering Cancer Center, Hauppauge, New York
Horacio Cabo Dermatology Institute of Medical Reserch, University of Buenos Aires, Argentina
Scott Menzies Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW Australia
Wilhem Stolz Department of Dermatology, Allergology, and Environmental Medicine Clinic Thalkirchen, Hospital Munich
Masaru Tanaka Department of Dermatology, Tokyo Women's Medical University Medical Center East, Japan
Harold Rabinovitz Department of Dermatology Medical Collage of Georgia
Rainer Hofmann-Wellenhof Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
Renato Marchiori Bakos Department of Dermatology, Hospital de Clınicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Iris Zalaudek Department of Dermatology, University of Trieste, Italy
Giovanni Pellacani Department of Dermatology, University of Rome La Sapienza, Rome, Italy
Anna Varela Veiga Department of Dermatology, University Hospital Complex of Ferrol, Spain
Laura Rosende Maceiras Department of Dermatology, University Hospital Complex of Ferrol, Spain
Cristina de las Heras-Sotos Department of Dermatology, University Hospital Complex of Ferrol, Spain
Giuseppe Argenziano Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy

Keywords:

dermoscopy, dermatoscopy, digital monitoring, multiple nevi , total body photography

Abstract

Introduction: In patients with multiple nevi, sequential imaging using total body skin photography (TBSP) coupled with digital dermoscopy (DD) documentation reduces unnecessary excisions and improves the early detection of melanoma. Correct patient selection is essential for optimizing the efficacy of this diagnostic approach.

Objectives: The purpose of the study was to identify, via expert consensus, the best indications for TBSP and DD follow-up.

Methods: This study was performed on behalf of the International Dermoscopy Society (IDS). We attained consensus by using an e-Delphi methodology. The panel of participants included international experts in dermoscopy. In each Delphi round, experts were asked to select from a list of indications for TBSP and DD.

Results: Expert consensus was attained after 3 rounds of Delphi. Participants considered a total nevus count of 60 or more nevi or the presence of a CDKN2A mutation sufficient to refer the patient for digital monitoring. Patients with more than 40 nevi were only considered an indication in case of personal history of melanoma or red hair and/or a MC1R mutation or history of organ transplantation.

Conclusions: Our recommendations support clinicians in choosing appropriate follow-up regimens for patients with multiple nevi and in applying the time-consuming procedure of sequential imaging more efficiently. Further studies and real-life data are needed to confirm the usefulness of this list of indications in clinical practice.

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