Supplemental Material for JAAD-D-26-01408 — Risk-Adapted Monitoring of Melanocytic Lesions With Peripheral Globules: A Longitudinal Cohort Study on Melanoma Risk Stratification

Methods

Full modeling details, including priors, convergence diagnostics, and model-fit metrics. - Supplementary Results: Details of model convergence, patient-level heterogeneity, and out-of-sample predictive performance. - Supplementary Figure 1: Histopathologically confirmed benign melanocytic nevi with peripheral globules. Six lesions (a-f) biopsied or excised because of documented change, age-related concern, growth or persistence of peripheral globules, or clinical caution during digital monitoring; all benign on histopathology. - Supplementary Figure 2: Histopathologically confirmed melanomas presenting with peripheral globules across different age groups.

Six lesions (a-f) in patients aged 22 to 78 years, including melanoma in situ and invasive melanomas (Breslow 0.3-0.8 mm), illustrating the role of globule symmetry, size and color variability, associated central structures, and patient-level melanoma risk. - Supplementary Figure 3: Sequential handheld dermoscopic images at baseline, 3 and 6 months of a lesion in a 55-year-old patient with irregular peripheral globules and central asymmetry; excision revealed invasive melanoma (Breslow 0.5 mm). - Supplementary Figure 4: Sequential handheld dermoscopic images at baseline, 3 and 6 months of a lesion in a 22-year-old woman with a family history of melanoma, showing rapid growth and a chaotic dermoscopic pattern; excision revealed invasive melanoma (Breslow 0.45 mm). - Supplementary Table 1: Comparison of lesion-level characteristics between excised and non-excised lesions. - Supplementary Table 2: Secondary analysis restricted to the 143 excised lesions, showing melanoma-specific dermoscopic structures and other independent predictors of adverse histopathologic outcome.