Compliance with serial dermoscopic monitoring: An academic perspective

Published:September 21, 2016DOI:


      For even seasoned practitioners, early melanomas can be difficult to distinguish from melanocytic nevi. Although serial digital dermoscopy is considered by many to be the gold standard for monitoring patients at high risk, poor compliance can seriously alter efficacy. In 2014, a concerning compliance rate of 25% was reported from a single, private clinic. Information is currently limited regarding the determinants of compliance and whether patients at high risk return at an acceptable rate.


      We sought to determine the compliance rate within the pigmented lesions clinic at our academic institution and identify demographic variables that may influence adherence.


      A retrospective review was conducted using 120 patient charts.


      An overall compliance rate of 87.5% was observed with 63.3% of patients returning within 1 month of the recommended interval. The most notable risk factor for noncompliance was patient age between 20 and 29 years. Factors promoting adherence include a personal history of melanoma, greater than 5 serially monitored nevi, and a personal history of atypical nevi.


      The external validity is limited and the sample size is small.


      These findings contradict concerns that adherence to serial monitoring is unacceptably poor and demonstrate that compliance is highest for patients with the greatest inherent risk.

      Key words

      To read this article in full you will need to make a payment
      AAD Member Login
      AAD Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features

      Purchase one-time access:

      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Argenziano G.
        • Albertini G.
        • Castagnetti F.
        • et al.
        Early diagnosis of melanoma: what is the impact of dermoscopy?.
        Dermatol Ther. 2012; 25: 403-409
        • Piccolo D.
        • Ferrari A.
        • Peris K.
        • et al.
        Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer-aided diagnosis of 341 pigmented skin lesions: a comparative study.
        Br J Dermatol. 2002; 147: 481-486
        • Gadens G.A.
        Lack of compliance: a challenge for digital dermoscopy follow-up.
        An Bras Dermatol. 2014; 89: 242-244
        • Argenziano G.
        • Mordente I.
        • Ferrara G.
        • et al.
        Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocols.
        Br J Dermatol. 2008; 159: 331-336
        • Schiffner R.
        • Schiffner-Rohe J.
        • Landthaler M.
        • et al.
        Long-term dermoscopic follow-up of melanocytic nevi: clinical outcome and patient compliance.
        Br J Dermatol. 2003; 149: 79-86
        • Menzies S.W.
        • Gutenev A.
        • Avramidis M.
        • et al.
        Short-term digital surface microscopic monitoring of atypical or changing melanocytic lesions.
        Arch Dermatol. 2001; 137: 1583-1589
        • Bauer J.
        • Blum A.
        • Strohhacker U.
        • et al.
        Surveillance of patients at high risk for cutaneous malignant melanoma using digital dermoscopy.
        Br J Dermatol. 2005; 152: 87-92