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Photographic surveillance of the skin

What is photographic surveillance of the skin?

Photographic skin surveillance generally refers to a screening program for those at high risk for evil one melanomafor example, the MoleMap New Zealand mole mapping program.

The main components are:

  • Clinical examination of the skin and dermoscopy to identify and evaluate the lesions of interest.
  • Full length photography
  • Close-up and dermoscopic photographs of melanocytic naevi and other skin lesions
  • Detection of new or modified injuries at follow-up visits.
  • Expert diagnosis and management recommendations.

Digital photographic surveillance of the skin may include:

  • Risk assessment: age, medical and family history, skin typing, sun exposure.
  • Patient education on sun protection, moles and melanoma.
  • Examination of the skin by a trained health professional.
  • High-quality digital images.
    • Standardized whole body postures.
    • Close-up macro images of lesions of interest
    • Dermoscopic images of worrisome injuries
  • Image evaluation by a skin expert. Cancer, generally a dermatologist
  • A report to the patient and / or the referring healthcare professional.
  • Follow-up of digital dermoscopic images in 3 to 6 months (short-term monitoring)
  • Follow-up imaging of all injuries with imaging at 1 to 2 year intervals or as recommended by a physician
  • A secure database and transfer system to store images and reports.
  • Copies of the images for the patient or doctor to aid in self-examination of the skin.

The patient will be asked to remove at least outer clothing. Makeup, nail polish, and jewelry should be completely removed before the procedure. Long hair must be tied

Skin Photo Surveillance by MoleMap New Zealand

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Recording the image

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Full body images

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Blow to the body

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Macro and dermoscopic images of worrying lesion

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Repeat the image. The red border indicates that the injury has changed.

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Standardized report

What injuries should be photographed?

Troubling lesions are those that have characteristics consistent with melanoma or another form of skin cancer (such as basal cell carcinoma or scaly cell carcinoma). Characteristically, skin cancers enlarge or change over periods of weeks to years.

Melanoma characteristics are defined by the ABCDE rule and the Glasgow 7-point checklist. These are a useful guide, but may not be identified early. melanomas or atypical forms Not all skin lesions with these characteristics are melanomas; Many turn out to be harmless.

ABCDE rule Glasgow 7 Point Checklist
A
yes
C
re
me
Asymmetry
Border irregularity
Color variation
Diameter greater than 6 mm
Evolving (expanding, changing)
Main features:
Size change
Irregular shape
Irregular color
Minor features:
Diameter> 7mm
Inflammation
Oozing
Change in feeling

No melanoma (or keratinocytic) Skin cancers are much more common than melanoma. These generally present as growing skin lesions, which may be crusty, ulcerated, or bleeding.

If you have skin lesions that worry you because they are new, enlarged, or look distinctive or unusual, see your doctor. If your doctor is also concerned, he or she may recommend removal (biopsy), follow-up appointment, referral to a specialist or photographic surveillance of the skin.

Who should undergo photographic surveillance of the skin?

Photographic skin monitoring is particularly helpful for people who have:

  • Many moles (more than 50–100)
  • Dysplastic or atypical nevi: moles that are large, unusual in color or shape
  • Moles on the back, which can be difficult to monitor
  • Previous history of melanoma
  • Strong family history of melanoma
  • Clear skin that has suffered severe or repeated sunburns.
  • Concerns about moles or individual freckles, for example, about their recent appearance or change.

Photographic surveillance of the skin is most useful for pigmented moles: light to dark brown (instead of pink) spots. Accurate diagnosis depends on evaluation of the structure of the pigment.

What are the advantages of photographic skin monitoring?

Photographic surveillance of the skin is intended to diagnose melanoma at the earliest possible stage, by identifying new melanocytic lesions or the change in pre-existing melanocytic lesions. These features may be suspected of melanoma if the injury It also has a disordered structure clinically or in dermoscopy.

Compared to a self-examination of the skin or an examination by a non-specialized physician, photographic surveillance of the skin has several advantages.

  • The previous record can be used to determine if an injury of interest is new or has changed.
  • If the doctor determines that an injury meets the criteria for removal, this can be done at the earliest possible stage, reducing the risk of melanoma and minimizing surgery.
  • If a lesion is new or has changed, but does not meet the threshold for removal, images can be re-imaged and viewed carefully.
  • Non-structural, unchanged lesions are highly unlikely to be melanoma, so removal may not be necessary, reducing the potential cost, risks, and complications of surgery.
  • Digital photographic surveillance of the skin can be performed close to where you live, reducing the need to visit a dermatologist at a remote center.
  • Expert pre-evaluation: In many areas there may be a long delay in getting an appointment with a dermatologist.
  • Peace of mind for the patient and their health professional (s).

What are the risks of photographic skin monitoring?

Customers should be aware that any detection system has risks.

  • There may be melanoma in a hidden location that has not been photographed, such as the scalp or genitals.
  • Early melanoma and other forms of skin cancer may seem like a benign skin lesion, and could be lost (false negative).
  • A harmless lesion can be misdiagnosed as melanoma, resulting in unnecessary surgery and alarm (false positive).
  • Melanoma can grow rapidly, particularly nodular melanoma; It may reach a dangerous size before the next planned visit.

Should I have photographic surveillance of the skin?

If you are considering undergoing photographic skin monitoring, discuss the procedure with your own doctor. Ensure:

  • The procedure includes the elements discussed above.
  • Written information is provided about the procedure, its deficiencies and benefits.
  • You and your regular doctor receive a report that explains recommendations for the follow-up or treatment of injuries that concern you, your own doctor, or the skin injury imaging service.
  • If you are concerned about a skin injury or are at high risk for skin cancer, a health professional with experience in skin exams and skin cancer screening will do a full skin exam.