Mobile melanoma management

You know public awareness of melanoma has gone mainstream when there’s a smartphone app just for viewing skin cancer images. A friend showed me on his BlackBerry the other day pictures of skin malignancies from online databases. Checking potentially wayward moles against examples on your phone might seem a little neurotic, but the opposite tendency of being oblivious to the risks of skin cancer is what’s really crazy.

The company that created the phone app, Opticon Data Research, goes well beyond simply providing photos of nasty melanomas. Using a webcam or digital camera you can analyze images of your own moles on downloaded software that compares them against hundreds of documented cases of malignancies. The software, called MoleSense, can be used to map the size, shape and location of moles over your entire body. The product is designed to identify moles that might be dangerous and which deserve professional attention.

Unless you live in the sticks, I’d recommend you save the $60 and go straight to a dermatologist instead. There’s been a lot of technical progress in mole mapping done by physicians in which high-res digital photos are taken of the entire skin surface under standardized conditions. A baseline record is then available for follow-up exams in which new or changing moles can be detected. My dermatologist doesn’t do this, but instead examines me from head to toe visually. I’m OK with her low-tech approach, as I believe a conscientious doctor with a well-trained eye is more likely to spot trouble than a lazy doctor who relies too much on technology.

Some dermatologists also perform what’s called dermoscopy to monitor equivocal lesions. This noninvasive technique uses magnifying optics and immersion oil to detect potentially dangerous changes in the skin that can be missed by the naked eye. Just as some innocent-looking moles can be malignant, some atypical lesions are benign. Using dermoscopy, the hope is that unnecessary biopsies and surgeries can be avoided.

I’m inclined to believe this technique has clinical merit. My dermatologist scraped a mole from my chest two weeks ago (found to be benign) that is now scabbed over and itchy. It won’t be fully healed for days. I’d prefer to avoid the risk of infection that every biopsy poses, to say nothing of the cost of the procedure. There are some suspicious moles for which it’s smart to go straight to biopsy, and others that can be safely followed to watch for changes. This is where well-executed dermoscopy may come in.

The incidence of skin cancer is skyrocketing nationwide, and everyone who's at risk for some form of the disease—which is most of us—should see a dermatologist for a baseline exam. Melanoma is rarely deadly when caught early, so whether you monitor your skin by smartphone or with a smart doc, your goal should be to keep a close watch on moles that might be acting up.