Medical Edge Newspaper Column

Complete Skin Exam Key To Diagnosing Melanoma

Sept. 3, 2006
DEAR MAYO CLINIC:
I have read some articles about a new method for detecting early skin cancer. It's called SolarScan, and it was developed in Australia. Is anyone in the United States using it? -- St. Louis Park, Minn.

ANSWER:
SolarScan is a computer-assisted imaging device that may make it easier to diagnose melanoma
-- the deadliest form of skin cancer. So far, this device is not available in the United States.

Typically, a doctor diagnoses melanoma with a skin examination, followed by a biopsy. Some melanomas are relatively easy to diagnose, but others may be subtle or unusual, making it more difficult to accurately diagnose.

If detected and removed early, melanoma is curable. If there is a delay in removal, and cells spread to lymph nodes or other organs, treatment can be more difficult. Researchers are seeking better ways to catch melanoma early. SolarScan is one example. Recent research showed that SolarScan performed well in the diagnosis of melanoma.

As these imaging devices become more refined, dermatologists will use them as a tool to help diagnose melanoma. But we can't expect an instant, accurate diagnosis from an automated device. One limitation is that computer-assisted imaging devices may not be as accurate for the tricky cases, such as melanomas that look different than your average melanoma -- pink or red (amelanotic) melanoma or scar-like (desmoplastic) melanoma.

Other efforts are under way to improve melanoma diagnosis. A basic, yet important area is public and professional education. The message: If you see changes in a skin lesion, see your doctor.

Two other newer tools to assist in early diagnosis of melanoma are epiluminescence microscopy (where skin spots are magnified for closer inspection) and total body digital photography for patients with numerous skin lesions. Both are used widely in the United States.

You are correct that SolarScan was developed in Australia. I had the opportunity to visit Australia recently and observed SolarScan in use. It's widely available there. The U.S. Food and Drug Administration hasn't yet approved SolarScan. Testing is under way to confirm its accuracy.

The optimal use of emerging technology takes time to define. SolarScan and other melanoma imaging devices under development will likely someday be used to enhance the diagnostic capabilities of expertly trained clinicians. But the most important step in diagnosing melanoma is still performing a complete skin examination and being able to pick out -- from the many skin spots on most people's bodies -- the ones that are suspicious. A machine cannot do that.

-- Clark C. Otley, M.D., Chair, Dermatologic Surgery, Mayo Clinic, Rochester, Minn.