Digital Epiluminescence Microscopy Monitoring of High-Risk Patients

Abstract
ALTHOUGH EXPERIENCED dermatologists diagnose most melanomas with the unaided eye, epiluminescence microscopy (ELM) enhances the diagnostic accuracy of early cases and helps select pigmented lesions that require biopsy.1-5 Most dermatologists agree that patients with atypical or dysplastic nevi are at increased risk of developing melanoma,6 and they follow up patients with total cutaneous examination either annually or every 4 to 6 months. Since dysplastic nevi either are precursors to melanoma7-13 or identify persons at risk of developing melanoma,14-16 intense surveillance of atypical nevi and new pigmented lesions is performed so that melanomas can be found and removed in the early curable phase. For people with dysplastic nevi, the risk of developing melanoma increases with a personal history of melanoma, and each first-degree relative with melanoma confers risk (eg, 1 first-degree relative: relative risk = 4).16,17

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