Long Term Monitoring
Long Term Monitoring
- Is mainly used for randomly selected lesions with no features to suggest malignancy, typically in patients with multiple nevi.
- Long-term follow-up changes observed in melanomas are different from those observed in nevi.
- Melanomas more frequently grow asymmetrically (change in size and shape), whereas nevi more frequently grow symmetrically (size but not in shape).
- Structural changes and color changes are more frequently observes in melanomas than in nevi.
Classification of Changes
|Significant change||Non-significant change|
|Asymmetric enlargement||Darker or lighter overall appearance|
|Focal changes in pigmentation or structure||Change in number or distribution of brown globules|
|Regression features||Decrease in number of black dots|
|Change in color||Disappearance of inflammatory reaction|
|Disappearance of small foci of pigment network within central portion of the lesion and replacement by diffuse brown pigmentation|
Management approach for nevi with peripheral grim of globules
In contrast to melanomas, enlarging melanocytic nevi typically show symmetrical enlargement without structural changes. The dermoscopic sign of peripheral rim of brown globules is highly characteristic for symmetrically enlarging melanocytic nevi in youth. Once these nevi enter senescence, the peripheral globules are no longer visible and the nevus will usually manifest a reticular or homogenous pattern.
|<20 years old||20–50 years old||>50 years old|
|Reassure||Follow-up to insure normal growth and behavior (STMM)||Digitally monitor until senescent. If not able to digitally monitor then consider biopsy|
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