Changing naevi of more concern in adults than children and adolescents

January 01, 0001

Changing naevi of more concern in adults than children and adolescents

The aim of this retrospective cohort study performed from April 1, 1998, through May 31, 2007 was to determine whether certain patient demographics are associated with poorer specificity for the diagnosis of melanoma in nevi undergoing short-term sequential digital dermoscopic imaging. It was conducted at the Sydney Melanoma Diagnostic Centre, a tertiary referral institution, Australia. A total of 2497 benign melanocytic lesions in 1765 patients undergoing short-term sequential digital dermoscopic imaging during 2.5 to 4.5 months (42.3% male; mean age, 40 years; age range, 1-86 years).

The only variable significantly associated with nevus change was age group. When compared with the middle-aged (aged 36-50 years) group, the odds of change were significantly increased in the child and adolescent (aged 0-18 years: odds ratio, 2.60), young adult (aged 19-35 years: 1.50), and elderly (greater than 65 years old: 2.04) age groups. Within the changed benign lesions, a significant association was observed between histologic subtype and age group. The proportion of changed lesions of the banal nevi type decreased and the proportion of the dysplastic nevi type increased with age. In the elderly group, 75.9% of changed lesions were of the dysplastic nevi type compared with 35.7% in the youngest group.

The researchers concluded:  "A poorer specificity is observed for the diagnosis of melanoma for nevi undergoing short-term sequential digital dermoscopic imaging in children and adolescents (75.7%) and elderly patients (77.9%) compared with other patients (84.6%)."

Dermoscopy can help minimise excisions and this study does not alter decisions made using the three-point or seven-point checklists.

For the full abstract, click here.

Arch Dermatol  147(6):655-659, June 2011 © 2011 American Medical Association
Variables Predicting Change in Benign Melanocytic Nevi Undergoing Short-term Dermoscopic Imaging. Scott W. Menzies, Mary L. Stevenson, Davide Altamura and Karen Byth.

Category: S. Skin. Keywords: change, variables, predicting, benign, melanocytic, nevi, retrospective cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 29 July 2011

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