MITF E318K: A rare homozygous case with multiple primary melanoma

Melanoma Diagnosis With 3D Total-Body Photography

Skin cancer is a growing global health challenge, emphasizing the need for early detection. In recent years, 3D total-body photography has emerged as a promising tool in dermatology. This non-invasive imaging technique provides a comprehensive visual representation of a patient's skin, enabling the early detection of suspicious lesions and the surveillance of existing nevi. Despite its promising role in early melanoma detection, ongoing research is essential to validate its real-world impact and address its current limitations. Although it enhances diagnostic accuracy, this technique currently does not replace the need for a thorough examination by a dermatologist. This review provides a comprehensive overview of the most recent findings on the application of 3D total-body photography in melanoma diagnosis.

Genetic testing for familial melanoma

While the average lifetime risk of melanoma worldwide is approximately 3%, those with inherited high-penetrance mutations face an increased lifetime risk of 52-84%. In countries of low melanoma incidence, such as in Southern Europe, familial melanoma genetic testing may be warranted when there are two first degree relatives with a melanoma diagnosis. Testing criteria for high incidence countries such as USA, or with very-high incidence, such as Australia and New Zealand, would require a threshold of 3 to 4 affected family members. A mutation in the most common gene associated with familial melanoma, CDKN2A, is identified in approximately 10-40% of those meeting testing criteria. However, the use of multi-gene panels covering additional less common risk genes can significantly increase the diagnostic yield. Currently, genetic testing for familial melanoma is typically conducted by qualified genetic counsellors, however with increasing demand on testing services and high incidence rate in certain countries, a mainstream model should be considered. With appropriate training, dermatologists are well placed to identify high risk individuals and offer melanoma genetic test in dermatology clinics. Genetic testing should be given in conjunction with pre- and post-test consultation. Informed patient consent should cover possible results, the limitations and implications of testing including inconclusive results, and potential for genetic discrimination. Previous studies reporting on participant outcomes of genetic testing for familial melanoma have found significant improvements in both sun protective behavior and screening frequency in mutation carriers.