In this edition of JAMA Dermatology, Guitera et al1 report the outcomes from a structured surveillance program of total-body photography (TBP), sequential digital dermoscopy imaging (SSDI), and skin examinations every 6 months in a population at very high risk for melanoma. Of 593 patients, 113 (19%) had a new melanoma diagnosed during the median 2.8-year follow-up period. Most melanomas were in situ (117 of 171 [68%]), and 7 melanomas (4%) were thicker than 1 mm. Few melanomas (<10%) were detected by the patient. Rather, most melanomas were detected by the clinician using specialized imaging. At first glance, this is an exceptional level of melanoma detection and a testament to the value of intense surveillance augmented by technology. Given the resources required to achieve this level of care, including specialized software and physician time, it is important to consider how best to study the impact of this intense level of surveillance and determine when it is most beneficial and appropriate for use in clinical practice.
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Ferris LK. Early Detection of Melanoma: Rethinking the Outcomes That Matter. JAMA Dermatol. Published online March 17, 2021. doi:10.1001/jamadermatol.2020.5650
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