3D Total-Body Photography in Patients at High Risk for Melanoma
Clinical Summary
View sourceWhat was studied
A randomized clinical trial in adults at high risk of melanoma compared usual care vs usual care plus 3D total‑body photography and sequential digital dermoscopy imaging every 6 months via teledermatology over 24 months. Outcomes were numbers/rates of excisions or biopsies and histopathology results.
Key findings
Among 314 participants, 1527 excisions were performed (905 intervention vs 622 control) across 226 people, yielding 67 melanomas (4%) and 402 keratinocyte cancers (26%). Mean excisions per person were higher with the intervention (5.73 vs 3.99; P=.02); fewer melanomas were detected in the intervention (24) than control (43) with a lower incidence rate (2.03 vs 3.62), and at 1 year the melanoma rate per person was lower but not statistically significant (0.08 vs 0.16), while KCs (0.86 vs 0.42) and excisions/biopsies (2.01 vs 1.39) per person were higher with the intervention.
Study limitations
Single research hospital setting with a limited number of teledermatologists, limiting generalizability. The intervention bundled 3D‑TBP with SDDI, so effects of each component cannot be isolated. Teledermatology was added to usual care rather than compared head‑to‑head with usual care alone, and the 1‑year melanoma rate difference was not significant.
Clinical implications
In high‑risk patients, adding 3D‑TBP and SDDI via teledermatology increased excisions/biopsies and keratinocyte cancer detection but did not produce a statistically significant reduction in melanoma rate at 1 year. Expect higher procedure volumes without clear melanoma benefit over 12 months.
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