Consumer preferences for teledermoscopy screening to detect melanoma early

Introduction: ‘Store and forward’ teledermoscopy is a technology with potential advantages for melanoma screening. Any large-scale implementation of this technology is dependent on consumer acceptance. Aim: To investigate preferences for melanoma screening options compared with skin self-examination in adults considered to be at increased risk of developing skin cancer. Methods: A discrete choice experiment was completed by 35 consumers, all of whom had prior experience with the use of teledermoscopy, in Queensland, Australia. Participants made 12 choices between screening alternatives described by seven attributes including monetary cost. A mixed logit model was used to estimate the relative weights that consumers place on different aspects of screening, along with the marginal willingness to pay for teledermoscopy as opposed to screening at a clinic. Results: Overall, participants preferred screening/diagnosis by a health professional rather than skin self-examination. Key drivers of screening choice were for results to be reviewed by a dermatologist; a higher detection rate; fewer non-cancerous moles being removed in relation to every skin cancer detected; and less time spent away from usual activities. On average, participants were willing to pay AUD110 to have teledermoscopy with dermatologist review available to them as a screening option. Discussion and conclusions: Consumers preferentially value aspects of care that are more feasible with a teledermoscopy screening model, as compared with other skin cancer screening and diagnosis options. This study adds to previous literature in the area which has relied on the use of consumer satisfaction scales to assess the acceptability of teledermoscopy

Indolent systemic mastocytosis: a case and review of the current available treatment options

Mastocytosis denotes a heterogeneous group of disorders characterized by abnormal growth and accumulation of mast cells. Cutaneous mastocytosis is characterized by skin-limited disease and is the most common subtype. Systemic mastocytosis has extracutaneous organ involvement with variable symptomatology and prognosis. Clinical manifestations are secondary to mediator release or direct organ infiltration of mast cells. Current available treatment for systemic mastocytosis is non-curative with conventional symptom-directed therapy for all subtypes. Cytoreductive agents are available for those with refractory symptoms or extensive extracutaneous disease. To date, clinical responses remain mixed and systemic mastocytosis is still an incurable condition

Scanning for melanoma

Non-invasive diagnostic tools aim at increasing accuracy of melanoma diagnosis. Clinical naked eye observation in combination with dermoscopy can be regarded as the practical reference standard to identify lesions for histopathological evaluation. Pigmented lesions need to be evaluated in the context of patient history to identify risk factors for melanoma, followed by a dermoscopically-aided entire skin examination. Patients with identified risk factors should be further examined. Total body photography is widely used in the follow-up of high-risk patients (particularly those with numerous and dysplastic naevi) and can be coupled with digital dermoscopy or videodermoscopy. New noninvasive diagnostic aids comprise multispectral image analysis, reflectance confocal microscopy and computer assisted diagnostic systems. Also, molecular profiling of lesions is an emerging technique under investigation for melanoma diagnosis. © Copyright 2010 National Prescribing Service Ltd

Effects of a Chemical Sunscreen on UV-Induced Changes of Different Histological Features in Melanocytic Nevi

Several studies have investigated the effect of UV radiation on melanocytic nevi by using different approaches and different sources and types of irradiation.1 We read with interest the work of Carrera et al,2 and we would like to describe our experience also

Recent advances in diagnosing cutaneous melanomas

Early detection of lesions while minimising the unnecessary removal of benign lesions is the clinical aim in melanoma diagnosis. In this context, several non-invasive diagnostic modalities, such as dermoscopy, total body photography, and reflectance confocal microscopy have emerged in recent years aiming at increasing diagnostic accuracy. The main developments in this field are the integration of dermoscopy and digital photography into clinical practice

Clinical and dermoscopic features of porokeratosis of Mibelli

"-

Clinical and Dermoscopic Features of Agminated Blue Nevus

"-

Lacunarity Analysis: A Promising Method for the Automated Assessment of Melanocytic Naevi and Melanoma

The early diagnosis of melanoma is critical to achieving reduced mortality and increased survival. Although clinical examination is currently the method of choice for melanocytic lesion assessment, there is a growing interest among clinicians regarding the potential diagnostic utility of computerised image analysis. Recognising that there exist significant shortcomings in currently available algorithms, we are motivated to investigate the utility of lacunarity, a simple statistical measure previously used in geology and other fields for the analysis of fractal and multi-scaled images, in the automated assessment of melanocytic naevi and melanoma. Digitised dermoscopic images of 111 benign melanocytic naevi, 99 dysplastic naevi and 102 melanomas were obtained over the period 2003 to 2008, and subject to lacunarity analysis. We found the lacunarity algorithm could accurately distinguish melanoma from benign melanocytic naevi or non-melanoma without introducing many of the limitations associated with other previously reported diagnostic algorithms. Lacunarity analysis suggests an ordering of irregularity in melanocytic lesions, and we suggest the clinical application of this ordering may have utility in the naked-eye dermoscopic diagnosis of early melanoma