Detecting incipient melanomas when they are still featureless

Sequential Digital Dermoscopy Imaging (SDDI)

Whole Body Photography and SDDI can often find problems before they become more serious issues.

SDDI is a complicated term for a relatively simple concept.  A digital picture, or series of pictures, is taken of areas on the body that look like they may possibly develop into problems, and then other pictures are taken at a later time of exactly the same area.

microDERM D200Evo Dermatoscope - Touch

These digital images are stored in a personal skin image history file, compared to images taken before,  and then reviewed by an expert Dermatologist, looking for changes that have occurred over time.  High quality images, using recent innovations, not only allow comparison of size and shape, but also color and depth. Research studies have shown that digital monitoring can detect melanomas earlier*1, and that earlier detection can mean better outcomes*2.

New imaging technology and analysis techniques provide a significantly better opportunity for evaluation of the less obvious changes that may indicate a problem.  Studies are progressing to determine how these new technologies and methodologies may affect outcomes and the cost of treating melanoma*3.

Other new technologies, like IBM’s Watson, are being developed to use Artificial Intelligence (AI) to assist your doctors in their diagnosis and treatment using vast digital libraries of images.  These AI systems offer great promise for the future.

A Complete Dermoscopic Examination

A complete exam can now include the use of very high quality digital imaging cameras (Dermatoscopes), whole body cameras, color-controlled lenses and lights, high resolution monitors, and sophisticated software – all of which can allow an expert dermatologist to provide a more accurate evaluation and allow your doctor to provide earlier and more focused treatment.  The quality of the Dermatoscope, in particular, can make a significant difference.

Study Support

Multiple studies conclude that Sequential Digital Dermoscopy Imaging can detect incipient melanomas when they are still featureless. Interpretation of changes observed during follow-up depends on the length of follow-up.

A September 2006 Study “Identification of Clinically Featureless Incipient Melanoma Using Sequential Dermoscopy Imaging”, Harald Kittler, MD; Pascale Guitera, MD; Elisabeth Riedl, MD; et al, can be found by clicking here.

An Excerpt From This Study

Early recognition of cutaneous melanoma is of utmost importance to improve the prognosis of this potentially fatal disease. Primary melanoma of the skin usually begins in the epidermis with the proliferation of single cells as melanoma in situ. If melanoma is diagnosed at this noninvasive stage, the patient can be cured by excision of the primary tumor, but if melanoma becomes invasive, the chance of cure decreases as invasion thickness increases.

Recognition of early melanoma is a challenge to every dermatologist. Inspection of the skin using the unaided eye may be accurate for the diagnosis of advanced cases, but it is inaccurate for the diagnosis of incipient melanoma. Dermatologists are using noninvasive diagnostic tools such as dermoscopy to improve the detection rate of early melanoma, but even dermoscopy has limitations. Melanomas and, in particular, incipient melanomas may lack dermoscopy features specific to this disease.

It has recently been shown that these “featureless” melanomas can be recognized by sequential dermoscopy imaging.

Stolz et al and Braun et al were the first to report on the use of sequential digital dermoscopy for the surveillance of melanocytic skin lesions. This technique is used for short-term monitoring of single melanocytic lesions that are not suggestive enough to warrant excision at the patient’s first visit but not completely inconspicuous. In this setting, the criteria for selecting a lesion for monitoring have been clearly defined by Menzies et al, and the follow-up time is restricted to 3 months.

Another reason to use sequential imaging may be to monitor patients with multiple melanocytic nevi. In this setting, the physician usually monitors multiple lesions. The criteria for selecting lesions in patients with multiple nevi have not yet been clearly defined. Follow-up is usually longer than 3 months and varies from 6 to 12 months (long-term monitoring).

Research References

*1 Digital monitoring by whole body photography and sequential digital dermoscopy detects thinner melanomas. Marius Rademaker and Amanda Oakley, Journal of Primary Health Care Published: 2010 http://www.publish.csiro.au/HC/HC10268

*2 Emerging technologies for the detection of melanoma: achieving better outcomes, Cila HermanClin Cosmet Investig Dermatol. Published 2012 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508547/

*3 Selective Use of Sequential Digital Dermoscopy Imaging Allows a Cost Reduction in the Melanoma Detection Process. Isabelle Tromme, Brecht Devleesschauwer, Philippe Beutels, Pauline Richez, Nicolas Praet, Laurine Sacré, Liliane Marot, Pascal Van Eeckhout, Ivan Theate, Jean-François Baurain, Julien Lambert, Catherine Legrand, Luc Thomas, Niko Speybroeck Published: 2014
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109339