The importance of total-body photography and sequential digital dermatoscopy for monitoring patients at increased melanoma risk

J Dtsch Dermatol Ges. 2020 Jul;18(7):692-697. doi: 10.1111/ddg.14158. Epub 2020 Jun 29.


Background and objectives: The incidence of melanoma is rising and prevention plays an important role. Multiple nevi as well as a medical history of melanoma are important risk factors. In affected patients, a two-step algorithm consisting of total-body photography (TBP) and sequential digital dermatoscopy (SDD) is a helpful diagnostic tool.

Patients and methods: This was a retrospective observational study that lasted six years in order to evaluate the significance of the two-step algorithm. Cases were evaluated based on distinct dermoscopic patterns and statistical analyses were performed with the latest version of SPSS.

Results: 6020 dermoscopic images of 214 patients were included. TBP was performed at a mean interval of 16.9 months (SD ± 1.43 months), while SDD was performed every 9.9 months (SD ± 1.68 months). The number needed to excise was 4.6 and the number needed to monitor was 548. Excisions were mostly performed because dynamic changes were observed. A total of eleven melanomas were detected and had a mean tumor thickness of 0.44 mm (SD ± 0.15 mm; range 0.2-0.6 mm).

Conclusions: Invasive melanomas had a tumor thickness of less than 0.6 mm, thus providing evidence of an effective strategy for early melanoma detection. Excisions of benign nevi were minimized as indicated by a low number needed to excise.

Publication types

  • Observational Study

MeSH terms

  • Algorithms*
  • Dermoscopy / methods*
  • Humans
  • Melanoma / diagnosis*
  • Melanoma / pathology
  • Photography*
  • Retrospective Studies
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology
  • Time Factors