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February 2015

Worry About Developing Melanoma in the Pigmented Lesion Clinic: Does It Warrant a Solution?

Author Affiliations
  • 1Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Dermatol. 2015;151(2):128-129. doi:10.1001/jamadermatol.2014.2228

In this issue Moye and colleagues1 examine psychological distress in patients with atypical mole syndrome attending a pigmented lesion clinic (PLC) who are receiving biannual total body skin examination using total body digital photography (TBDP). The authors propose that TBDP, which involves high-resolution digital photography with professional lighting and standardized patient poses to document the body surface, has potentially important psychological benefits. The photographs generated through TBDP provide the physician with a record to compare potentially new and changing lesions in subsequent PLC visits; TBDP photographs can also be provided to the patient to aid in skin self-examination. Apart from whether use of TBDP leads to reduced biopsy rates or improvements in the benign to malignant ratio, the authors propose that the use of repeated TBDP justifies the time and associated costs because TBDP reduces worry about melanoma in those patients who might otherwise have to wait for biopsy results. In the study by Moye et al,1 137 patients with atypical mole syndrome (defined as having ≥50 nevi with at least 1 nevus measured at ≥8 mm in diameter and 1 atypical nevus with irregular borders or color variation) were recruited prior to their TBDP in PLCs at Emory University and University of Arizona; 50% of the participants had a personal history of melanoma. Participants were recruited, and their worry about melanoma was evaluated twice using standardized measures—both before a PLC visit and then on average 7 months later. There are 2 prominent study findings.

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