Patterns of Change During the Dermoscopic Follow-Up of Melanocytic Lesions in High Risk Patients

BACKGROUND: Melanomas and melanocytic nevi that change over time display different change patterns, correlated with histopathological features. METHODS: We performed a retrospective analysis of the dermoscopic images corresponding to 86 lesions excised due to the changes occurred during the follow-up period in patients at high risk for melanoma, and we drew a comparison between the changes occurring in melanomas and those occurring in melanocytic nevi. RESULTS: There were significant differences between the models of dermoscopic change characteristic to melanoma and those characteristic to melanocytic nevi. We observed changes with high specificity for the diagnosis of melanoma – asymmetric growth (Sp=90%), new structureless grey-blue areas (Sp=97.5%) or new grey-blue network (Sp=96.25%), new pseudopods or radial streaks (Sp=95%). CONCLUSION: Our study highlights highly specific changes whose presence should raise the suspicion of melanoma and lead to the excision of the lesion.