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SSE plus teledermoscopy unlikely to detect malignant lesions

Participants who used skin self-examination with or without mobile teledermoscopy did not detect higher-priority skin lesions found later during clinical skin examinations, according to recent study results.

In a pilot randomized trial, researchers assessed suspicious lesions selected by 10 participants at high risk for melanoma using mobile teledermoscopy (MTD) plus the asymmetry-color variation (AC) rule (intervention group) and 12 participants using the AC rule alone (control group) during skin self-examination (SSE). Lesion location patterns, lesions overlooked by patients, provisional clinical diagnoses, malignant tumor likelihood and participant pressure to excise lesions also were measured.

All participants received an AC rule fact sheet and standardized SSE instructions, and all underwent clinical skin examinations (CSE) 3 to 6 months after SSE.

Overall characteristics were similar between cohorts (60% male; 73%, personal history of melanoma; 59%, body areas with moles). One hundred seven lesions, with similar location patterns, were identified during SSE (66, intervention; 41, control).

CSE detected 42 additional lesions not noted by participants during SSE (20, intervention; 22, control), including one presenting as a dysplastic nevus, two basal cell carcinomas (one confirmed in the intervention group and one resolved before surgery in the control group), and one confirmed squamous cell carcinoma (intervention group). Researchers said a mean of two lesions were missed during SSE in both cohorts.

“Consumer-selected lesions were unlikely to be malignant, although more than one-third were dysplastic nevi,” the researchers reported. “During CSE, the dermatologist detected other higher-priority skin lesions. These lesions were in hard-to-see body areas and might have been missed during SSE.

“Future studies of MTD could benefit from targeting partner-assisted SSEs, increasing the number of SSE to generate more lesions submitted for telediagnosis, assessing the effect of dermatologists’ feedback between SSE rounds and submitting lesion location photographs.”

Disclosure: Researcher H. Peter Soyer, MD, is a co-founder and shareholder of e-derm-consult GmbH and is a shareholder and reports for MoleMap by Dermatologists Pty Ltd.