Abstract of
A high incidence of melanoma found in patients with multiple
dysplastic naevi using photographic surveillance
John W Kelly, Josephine M Yeatman, Cheryl Regalia, Grahame Mason and
Amanda P Henham
Electronically published Friday 4 July 1997.
Please submit comments by Wednesday 30 July 1997.
Abstract |
Objectives: To assess the incidence of melanoma
occurring prospectively in a cohort of patients with dysplastic
melanocytic naevi (DMN) and the relationships between incident
melanomas and preexisting naevi and between melanoma risk and
numbers of DMN. To examine the role of the patient versus the physician
in detection of melanoma and the relative value of surveillance
versus prophylactic excision.
Patients and setting: Two hundred and seventy eight
adults, each with 5 or more DMN was followed for a mean period of 42
months in a private dermatology practice. DMN were clinically
diagnosed.
Results: 20 new melanomas were detected
prospectively in 16 patients, corresponding to an age adjusted
incidence of 1835/100,000 person years. This represents a 46-fold
increase above that expected for the general population. Melanoma
risk rose with increasing numbers of DMN. The majority (13/20) arose
as new lesions and only 3 from DMN. Eleven were detected because of
changes evident in comparison with baseline photos and 9 were
detected by the patient or their partner.
Conclusions: Increasing numbers of DMN are
associated with increasing melanoma risk. Surveillance enabled
early diagnosis of melanoma and was very much more cost effective in
preventing life-threatening melanoma than prophylactic excision
of DMN.
©MJA 1997.
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© 1997 Medical Journal of Australia.
