Comparative analysis of dynamic clinical and dermatoscopic characteristics of single and multiple nevi in patients with risk factors for malignant melanoma


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Abstract

Background. Currently, the benefits of dynamic clinical and dermatoscopic follow-up of patients with multiple melanocytic nevi and high risk for melanoma development are widely discussed. Long-term follow-up for patients with a history of melanoma is recommended in a number of international and domestic clinical guidelines for the diagnosis and treatment of this malignant skin tumor. On the other hand, there are practically no data on the management tactics and frequency of observations for patients with single melanocytic nevi, which may have a potential risk of developing malignant melanoma. Objective. Comparison of the frequency of detection of clinical and dermatoscopic changes in single and multiple nevi in patients with a high risk of developing malignant melanoma. Methods. The dynamic follow-up program included 75 patients with one or more risk factors for the development of malignant melanoma, distributed in group I - 43 patients (50 or more melanocytic nevi) and in group II - 32 patients (<50 melanocytic nevi). The patients underwent a questionnaire survey, a clinical dermatological examination, and double photo-mapping with an observation interval of at least 2 months. If significant dermatoscopic changes were detected, an excisional diagnostic biopsy with histological examination was performed. When clinical or dermatoscopic signs suspicious of melanoma were detected, the diagnosis was verified in the settings of an oncological institution. Results. During the follow-up period, out of 9676 studied melanocytic neoplasms in group I, 473 (4.89%) had dynamic dermatoscopic changes, of which 60 (12.7%) were removed with subsequent pathomorphological examination. In group II, 122 (9.58%) of 1274 melanocytic neoplasms changed during dermatoscopic monitoring. Five (4.1%) lesions out of 122 with clinical and dermatoscopic changes were excised for pathomorphological verification of the diagnosis. The proportion of histologically verified melanomas among neoplasms with significant dermatoscopic changes in patients with single nevi was 40%, in patients with multiple nevi - 9.1%. Conclusion. It was found that in patients with single melanocytic nevi and risk factors for the development of melanoma, dynamic changes in dermatoscopic structures in melanocytic nevi were detected no less frequently than in patients with multiple melanocytic nevi (P=0.022). The necessity of including patients with single melanocytic nevi and risk factors in dynamic dermatoscopic follow-up was substantiated.

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About the authors

I. I Vakhitova

Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology

Anna V. Michenko

Medical Research and Education Center, Lomonosov Moscow State University; Central State Medical Academy of Department of Presidential Affairs

Email: amichenko@mail.ru
Cand. Sci. (Med.), Associate Professor at the Department of Dermatovenereology and Cosmetology

K. S Titov

A.S. Loginov Moscow Clinical Scientific Center; RUDN University

A. Yu Brazhnikov

Sechenov University

D. V Romanov

Sechenov University; Research Center for Mental Health

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