Table 3. Number of Clinic Visits Attended, Lesions Surgically Excised, and New Melanoma Diagnoses During the 12 Months After Randomization.
| Clinical outcome | No. (%)a | Effect, risk ratio (95% CI) | |
|---|---|---|---|
| Control | Intervention | ||
| No. of patients | 51 | 49 | NA |
| No. of clinic visits, median (IQR) | 1 (0 to 6) | 2 (0 to 9) | 1.5 (1.1 to 2.1) |
| No. of skin lesions surgically excised, median (IQR) | 0 (0 to 10) | 1 (0 to 5) | 1.1 (0.6 to 2.0) |
| Effect, difference in proportions (95% CI) | |||
| Participants with ≥1 surgical excision of skin lesion | 21 (41) | 28 (57) | 16 (−3 to 35) |
| Participants with new keratinocyte cancer diagnoses | |||
| Squamous cell carcinoma | 7 (14) | 3 (6) | NA |
| Basal cell carcinoma | 8 (16) | 9 (18) | NA |
| Totalb | 11 (22) | 12 (25) | 1 (−18 to 15) |
| Participants with new melanoma diagnoses, stagec | |||
| 0 | 1 (2) | 6 (12) | NA |
| IA | 1 (2) | 2 (4) | NA |
| IB | 0 | 0 | NA |
| IIA | 0 | 0 | NA |
| IIB | 0 | 0 | NA |
| IICd | 1 (2) | 0 | NA |
| Totale,f | 3 (6) | 8 (16) | 10 (−2 to 23) |
| New melanoma diagnoses prompted by visit type | |||
| Unscheduled visit | 0 | 5 (10) | 10 (2 to 19) |
| Scheduled visit | 3 (6) | 3 (6) | 0 (−9 to 10) |
Abbreviation: NA, not applicable.
All values reported are frequencies (column percentages) unless otherwise indicated. Percentages may not sum to 100 owing to rounding.
In the intervention group, 2 participants had 2 keratinocyte diagnoses and 1 participant had 3; and in the control group, 4 participants had 2 keratinocyte diagnoses, 1 participant had 3, and 1 participant had 9.
According to guidelines from the American Joint Committee on Cancer.22
The stage IIC melanoma was a desmoplastic melanoma with a Breslow thickness of 4.5 mm diagnosed at a routinely scheduled 6-month follow-up visit.
Among the 11 participants diagnosed with new melanomas, there were a total of 13 melanoma diagnosed because 1 participant in the intervention group and 1 in the control had 2 melanoma diagnoses each. At the patient level, the unadjusted odds ratio for a new melanoma diagnosis (intervention vs control) was 3.1 (95% CI, 0.8 to 12.5). After accounting for the number of prior melanomas (<2 vs ≥ 2 prior melanomas), the adjusted odds ratio (intervention vs control) was 2.6 (95% CI, 0.6 to 10.7).
One participant with melanoma had a local recurrence of lentigo maligna initially diagnosed in 2017 that required re-excision because margins were involved. The patient detected recurrence at the site of the scar in 2019 and the teledermatologist recommended urgent review. Pathology revealed lentigo maligna (evidence of the previous scar was seen in the superficial dermis).