Atypical nevi (pigmented moles that may change shape or have irregular borders) have been identified as the strongest risk factor for melanoma (a type of skin cancer), according to the article. The presence of numerous atypical nevi can make SSE difficult, but because total removal of all moles is impractical, close self-monitoring for any changes is key in detecting moles that may be cancerous. Patients have a better chance of survival if melanoma is detected early, according to the article. SSE is important because detection of changed or new moles by spouses or family members is the most common way skin cancer is currently discovered, and is associated with a reduced risk of melanoma.
Susan A. Oliveria, Sc.D., of the Memorial Sloan-Kettering Cancer Center, New York, and colleagues investigated whether access to photographs of their skin and moles would affect a patient's ability to detect new or changed moles during SSE.
Fifty patients (18 years or older) with five or more atypical nevi had digital photographs taken of their backs, chest and abdomen (where moles were present) and conducted skin self-examinations during visits to the Memorial Sloan-Kettering Cancer Center in New York. Patients were given copies of these "baseline" photographs. Next, researchers changed the appearance of existing moles and created new moles on the patients using cosmetic eyeliner pencil in a color that most closely matched each patient's mole color. The new and altered moles totaled approximately 10 percent of each patient's total mole count.
The researchers found that compared to patients using SSE alone (without the digital photographs for reference), when patients also used digital photographs, their accuracy in correctly identifying new or changed moles increased by more than 10 percent (60.2 percent to 72.4 percent).
"Access to baseline photography improved the diagnostic accuracy of SSE on the back and chest or abdomen and improved detection of changing and new moles," the researchers write. "Our results suggest that baseline digital photography in tandem with SSE may be effective in improving the diagnostic accuracy of patients performing SSE," the authors conclude.
(Arch Dermatol. 2004;140:57-62. Available post-embargo at http://www.archdermatol.com)
To contact Susan A. Oliveria, Sc.D., call Esther Carver at 212-639-3573.
For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .
Journal
Archives of Dermatology