Variables Predicting Change in Benign Melanocytic Nevi Undergoing Short-term Dermoscopic Imaging

Abstract

Sequential digital dermoscopic imaging (SDDI) allows the detection of morphologic change of melanocytic lesions over time that permits the detection of early melanoma without specific dermoscopic features of malignant neoplasms (so-called featureless melanoma).^1-6 Sequential digital dermoscopic imaging is used in 2 general settings. Long-term SDDI is performed during standard surveillance periods (ie, 6-12 months) in patients with nevi that are not suspicious of melanoma. Long-term SDDI is usually performed in patients with multiple atypical nevi. In these patients, the observation of certain significant morphologic changes determines the need for excision.^2,3 Such changes occur in 4% to 5% of monitored nevi.^2,4,5 In contrast, short-term SDDI performed during a 3-month interval (range, 2.5-4.5 months) is used in patients with nevi that are more suspicious of melanoma.^1,6 Short-term SDDI is usually performed in patients with mildly atypical nevi who have a history of change or moderately atypical nevi without specific dermoscopic features of melanoma and without a history of change. Unlike long-term SDDI, virtually any morphologic change seen with short-term SDDI leads to the excision of these nevi.^1,3,6 Of importance, 99.2% of lesions remaining unchanged with short-term SDDI are benign. Nevertheless, 16% of benign nevi change during the short-term interval.⁶ In this study, we investigated whether certain patient characteristics predict change in benign nevi undergoing short-term SDDI. Such analysis helps to define whether certain patients are less suitable to undergo the technique because of a relatively poorer specificity for the diagnosis of melanoma.