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Research Letter |

Lesion Selection by Melanoma High-Risk Consumers During Skin Self-examination Using Mobile Teledermoscopy

Monika Janda, PhD1; Lois J. Loescher, PhD2; Parastoo Banan, MD3; Caitlin Horsham, BHlthSc1; H. Peter Soyer, MD3
[+] Author Affiliations
1School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
2College of Nursing, The University of Arizona, Mel and Enid Zuckerman College of Public Health, and Skin Cancer Institute, Tucson
3Dermatology Research Center, The University of Queensland, School of Medicine, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia
JAMA Dermatol. 2014;150(6):656-658. doi:10.1001/jamadermatol.2013.7743.
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Mobile teledermatoscopy (MTD) for the early detection of skin cancer uses smartphones with dermatoscope attachments to magnify, capture, and transfer images remotely.1 Using the asymmetry–color variation (AC) rule, consumers achieve dermoscopy sensitivity of 92.9% to 94.0% and specificity of 62.0% to 64.2% for melanoma.2

This pilot randomized trial assessed lesions of concern selected by consumers at high risk of melanoma using MTD plus the AC rule (intervention, n = 10) or the AC rule alone (control, n = 12) during skin self-examination (SSE). Also measured were lesion location patterns, lesions overlooked by participants, provisional clinical diagnoses, likelihood of malignant tumor, and participant pressure to excise lesions.

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Figure.
Lesion Location

A, Lesions of concern (based on the asymmetry–color variation [AC] rule) noted by intervention group (blue) and control group (green) during home skin self-examination (SSE). B, Lesions of concern (based on the AC rule) noted by the intervention group during home SSE (blue) and locations or provisional diagnosis of lesions noted by the dermatologist during clinical skin examination (CSE) (red). C, Lesions of concern (based on the AC rule) noted by the control group during home SSE (green) and locations or provisional diagnosis of lesions noted by the dermatologist during CSE (orange). Lesion provisional diagnoses in panel B (red) and panel C (orange) included dysplastic nevus, benign nevus, solar lentigo, seborrheic keratosis, angioma, diagnosis not possible, basal cell carcinoma, solar keratosis, dermatofibroma, melanoma, squamous cell carcinoma, and skin graft or scar.

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