Elsevier

Dermatologic Clinics

Volume 35, Issue 4, October 2017, Pages 439-445
Dermatologic Clinics

Mole Mapping for Management of Pigmented Skin Lesions

https://doi.org/10.1016/j.det.2017.06.004Get rights and content

Section snippets

Key points

  • Detecting melanoma, particularly in patients with numerous or atypical nevi, can be challenging for even the most skilled dermatologists.

  • Mole mapping involves using noninvasive imaging technology to enhance monitoring of new or changing melanocytic lesions.

  • Total-body photography and sequential digital dermoscopy imaging, together known as digital follow-up, are 2 prominent forms of noninvasive imaging technology used in mole mapping.

  • Noninvasive imaging technologies have been found to improve

Noninvasive imaging technology categories

TBP is a series of approximately 25 images of the entire skin surface that can be used as an adjunct to total-body skin examinations (TBSE), patient self–skin examinations (SSE), and dermoscopy. Photographic documentation serves as a baseline comparison for future TBSEs and allows a physician or patient to detect new lesions and any naked-eye changes in preexisting lesions. Once new or changing lesions have been identified by TBP, dermoscopy and SDDI can be used to further examine a suspicious

Challenges in melanoma screening

Diagnosis of melanoma is often multifactorial and incorporates patient history, gross and dermoscopic appearance, comparison with neighboring lesions, and identification of change. Although change can be the key and even sole sign of a melanoma,15 not all new or changing lesions are melanomas.16 Malignant features are particularly difficult to discern during early stages of melanoma growth, when preventing morbidity and mortality is more likely. One study found that dermoscopists were able to

Value of digital follow-up

Noninvasive imaging technology helps dermatologists catch early-stage melanomas while improving diagnostic accuracy.23, 24 As both stand-alone modalities and in combination, TBP and SDDI can confer specific clinical benefits.

TBP is particularly helpful in detecting changes in lesions that often do not follow the classic ABCDE (asymmetry, border irregularity, color variegation, diameter >6 mm, evolving) criteria. Feit and colleagues25 reported that 74% of melanomas detected in patients with TBP

Digital follow-up expansion

Since the advent of TBP in the late 1980s, noninvasive imaging technology has steadily grown.7 In 2000, 62% of dermatologists in academic institutions reported using TBP. In 2010, this proportion increased to 71%.34 That same year, a study surveying 49 US dermatology departments found two-thirds use TBP as a screening method. Of those who used TBP, one-third used digital TBP alone, one-third used digital with printed images of TBP, and the last third used printed TBP images alone.35 In 2013,

Current challenges and future directions of digital follow-up

Despite the impressive advances in this field, it seems that imaging modalities are concentrated largely in academic centers treating high-risk patients.36 More work needs to be done to improve usability and access to DFU. Limitations to using these new technologies include logistical constraints—additional time required and secure software to organize and store images—lack of knowledge regarding the utility of the technique, lack of training, and cost.34, 39

DFU is perceived by many

Summary

Identification of melanoma, particularly in patients with numerous or atypical nevi, is a challenge for even the most skilled dermatologists. Augmenting the clinical and dermoscopic examination with TBP and SDDI can improve diagnostic accuracy, detect earlier-stage melanomas, and reduce costs. Although barriers to adoption of these screening techniques exist, it is clear that noninvasive imaging technology is already revolutionizing the ways in which physicians and patients participate in

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    Disclosure Statement: The authors have no disclosures to make.

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