Early Detection of Melanoma in a Virtual Setting: The Role of Total-Body Dermoscopy in Virtual Full-Body Skin Exams
Abstract
Background and Rationale: Melanoma of the skin is the leading cause of skin cancer-related deaths. Yet, early detection remains as the best means of preventing death from melanoma. Early detection can be achieved by self-skin examination performed by the patient, or by a full-body skin exam performed by a trained medical provider. Based on risk factors for melanoma, screening guidelines recommend that individuals who are prone or at high risk for melanoma have a full-body skin exam at least annually. Full-body skin exams performed by medical providers can be further enhanced by the use of imaging technologies such as dermoscopy. Dermoscopy is a technique that allows the medical provider to visualize structures underneath the skin that are otherwise not visible to the naked eye, thereby improving early detection of melanoma. It is well-known that medical providers that use dermoscopy during their skin exams can improve early detection of melanoma as compared to those that do not use dermoscopy. However, this approach becomes challenging in settings without an on-site medical provider (e.g., deployment of military workers, medical missions, rural areas), and/or with regulations that limit the person-to-person exposure (e.g., Covid-19 pandemic or future pandemics). Consequently, patients who lack access due to these reasons may have an increased risk of delayed diagnoses, with the resulting increase in morbidity and death from melanoma. Therefore, in an effort to circumvent the lack of medical providers or social distancing policies, the current research proposal focuses in secondary prevention of melanoma, specifically in early detection. By using imaging technologies such as total body dermoscopy, there is an opportunity to detect melanoma early in the disease cycle, when it is still curable. Objective: The objective of this application is three-fold: (1) To determine the accuracy or precision of total body dermoscopy in diagnosing melanoma during a virtual full-body skin exam, (2) To identify subgroups of patients at high risk for melanoma that significantly benefit from virtual skin exams using total body dermoscopy, and (3) To determine the number of benign lesions needed to biopsy or refer in order to detect one melanoma. Potential Applications: The potential clinical applications of the current proposal include the virtual evaluation of individuals at high risk for melanoma, in particular those with limited access to skin exams performed by medical providers because of their geographical location or social distancing policies. Potential anticipated benefits for participants enrolled in the study include direct medical benefits (e.g., early detection of melanoma), indirect medical benefits (e.g., acquiring total body photos to use during their monthly self-skin exam), and benefit to others (e.g., individuals at high risk for melanoma with limited access to healthcare providers, future prospective trials). Patient-related outcomes would be immediate for participants enrolled in this one-visit assessment study. Potential risks associated with this study are minimal and may not entail any significant risks beyond those presented by a skin biopsy, which will be performed only to those participants with suspicious lesions on the skin. Skin biopsies are procedures commonly performed in dermatology to rule in, or rule out, a diagnosis and usually result in no more than minor discomfort (e.g., temporary pain associated with local anesthesia or wound), local pain, mild bleeding, or wound infection. Impact: By improving early detection of melanoma, the potential near-term impact of the current proposal is to lay the groundwork for halting the progress of melanoma in populations with limited access to in-person skin exams or who are encouraged to practice social distancing; thereby impeding progression and death from melanoma, while improving healthcare outcomes such as survival, quality of life, and healthcare-relat
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110716
Entities
People
- Natalia Jaimes
Organizations
- United States Army
- University of Miami