the introduction of skin self-photography as a supplement to skin self-examination for...

CLINICAL PEARL The introduction of skin self-photography as a supplement to skin self-examination for the detection of skin cancer Renuka Shenoy, BS, a Matthew A. Molenda, MD, b and Eliot N. Mostow, MD a,c Rootstown and Cleveland, Ohio S kin cancer is the most common cancer in the United States. Melanoma is the deadliest skin cancer, and data show that while only 20% of diagnosed patients have seen a dermatologist in the year before diagnosis, 63% have seen their primary care physician. 1 Because primary care practice and training are less focused on skin cancers, and because wait times can be substantial for dermatologists, we propose the Photos in Cancer Surveillance (PICS) program to encourage patients to be more proactive in monitoring their skin with readily available technology. Skin self-examination (SSE) is widely promoted, and studies show that a patient’s perception of a changing mole can be signiﬁcant. 2 Total body photography has been useful in detecting early melanomas, and 1 study recommended providing patients with baseline photography in addition to SSE to facilitate early diagnosis. 2 No literature specifically supports the use of skin self-photography (SSP) in detecting early melanoma, but the proliferation of smartphones and digital cameras makes SSP easy. While smartphone applications exist to help monitor skin lesions over time, we encourage patients to simply photograph nevi with their phone or camera. We offer additional instruction at the PICS program web site (www.picsprogram.org). If patients start simple SSP, they can choose to advance to apps if so inclined, but we believe our program fosters compliance. We hope the PICS program serves a role in detecting early melanoma, and we encourage patients to take more active roles in their health care. REFERENCES 1. Geller AC, Koh HK, Miller DR, Clapp RW, Mercer MB, Lew RA. Use of health services before the diagnosis of melanoma: implications for early detection and screening. J Gen Intern Med 1992;7:154-7. 2. Oliviera SA, Chau D, Christos PJ, Charles CA, Mushlin AI, Halpern AC. Diagnostic accuracy of patients in performing skin self-examination and the impact of photography. Arch Dermatol 2004;140:57-62. From Northeast Ohio Medical University, a Rootstown; Cleveland Clinic Dermatology and Plastic Surgery Institute, b Cleveland; and Case Western Reserve University School of Medicine, c Cleveland. Funding sources: None. Conflicts of interest include Healthpoint for Dr Mostow and Memorial SloaneKettering Cancer Center and Cleveland Clinic Innovations for Dr Molenda. Reprint requests: Eliot N. Mostow, MD, 566 White Pond Dr, Ste E, Akron, OH 44320. E-mail: [email protected]. J Am Acad Dermatol 2014;70:e15. 0190-9622/$36.00 Ó 2013 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2013.09.002 e15

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CLINICAL PEARL

The introduction of skin self-photography asa supplement to skin self-examination for

the detection of skin cancer

Renuka Shenoy, BS,a Matthew A. Molenda, MD,b and Eliot N. Mostow, MDa,c

Rootstown and Cleveland, Ohio

Skin cancer is themost common cancer in the United States. Melanoma is the deadliest skin cancer, and datashow that while only 20% of diagnosed patients have seen a dermatologist in the year before diagnosis,63% have seen their primary care physician.1 Because primary care practice and training are less focused

on skin cancers, and because wait times can be substantial for dermatologists, we propose the Photos in CancerSurveillance (PICS) program to encourage patients to be more proactive in monitoring their skin with readilyavailable technology.

Skin self-examination (SSE) is widely promoted, and studies show that a patient’s perception of a changingmole can be significant.2 Total body photography has been useful in detecting early melanomas, and 1 studyrecommended providing patients with baseline photography in addition to SSE to facilitate early diagnosis.2 Noliterature specifically supports the use of skin self-photography (SSP) in detecting early melanoma, but theproliferation of smartphones and digital cameras makes SSP easy.

While smartphone applications exist to help monitor skin lesions over time, we encourage patients to simplyphotograph nevi with their phone or camera. We offer additional instruction at the PICS program web site(www.picsprogram.org). If patients start simple SSP, they can choose to advance to apps if so inclined, but webelieve our program fosters compliance. We hope the PICS program serves a role in detecting early melanoma,and we encourage patients to take more active roles in their health care.

REFERENCES

1. Geller AC, Koh HK, Miller DR, Clapp RW, Mercer MB, Lew RA. Use of health services before the diagnosis of melanoma: implications for

early detection and screening. J Gen Intern Med 1992;7:154-7.

2. Oliviera SA, Chau D, Christos PJ, Charles CA, Mushlin AI, Halpern AC. Diagnostic accuracy of patients in performing skin self-examination

and the impact of photography. Arch Dermatol 2004;140:57-62.

From Northeast Ohio Medical University,a Rootstown; Cleveland

Clinic Dermatology and Plastic Surgery Institute,b Cleveland; and

Case Western Reserve University School of Medicine,c Cleveland.

Funding sources: None.

Conflicts of interest include Healthpoint for Dr Mostow and

Memorial SloaneKettering Cancer Center and Cleveland Clinic

Innovations for Dr Molenda.