Comparative diagnostic approach reduces unnecessary mole removal
MedWire News: Identifying the general pattern of moles in patients with large numbers could help reduce unnecessary removal of suspicious moles, say researchers.
They report that comparing questionable moles against the general pattern of patients' moles could help clinicians decide whether to monitor or remove moles more effectively.
Giuseppe Argenziano, from the Second University of Naples in Italy, and colleagues explain that most individuals with multiple moles have a signature group of moles that share a similar pattern and appearance.
Therefore, a lesion outside of this pattern should be considered suspicious even if it does not meet the clinical criteria for melanoma, while conversely, a lesion that individually would be considered suspicious may be completely normal if the individual is covered in similar looking moles.
The researchers compared two diagnostic approaches to dealing with suspicious moles in 17 patients, all of whom had more than 50 moles in total. The first involved looking at images of the form and structure of individual moles, while the second involved the same mole being assessed in the context of the patient's moles overall.
Of a total 190 moles assessed, at an average of 11 per patient, 184 had been monitored and six were removed. Of those removed, two were cancerous.
When moles were assessed based on their individual appearance, dermatologists decided that 55% of moles needed to be removed, but this fell to just 14% when the same moles were assessed in comparison with the patient's moles overall.
Both diagnostic approaches led dermatologists to recommend removal of the moles that turned out to be cancerous. But the researchers calculate that far fewer benign moles would need to be removed to find one melanoma if the appearance of single moles are compared with additional moles, at just 13.4 compared with 52.3 using assessment of single moles.
"Our study results suggest that unnecessary excisions can be reduced by the use of a comparative approach rather than a morphologic approach in dermoscopic evaluation of equivocal lesions among individuals with multiple nevi [moles]," the team concludes in the Archives of Dermatology.
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By Lucy Piper