Digital photography technique helps doctors track changes in moles
Heather Fraelick has fair skin peppered with many moles. Six years ago, she noticed a new spot. “It didn’t look like the photos you see of skin cancer, but it was the ugly duckling that stood out from the rest. I thought it was a bug bite, but after it became irritated, I went to the doctor.” Then 24, Fraelick was diagnosed with melanoma, the leading cause of cancer death in women ages 20 to 35. Rates of the disease in the US have tripled since 1980.
“I was absolutely shocked to learn how deadly melanoma can be,” says Fraelick, an athlete who played outdoor sports for years without sunscreen and visited a tanning salon before vacations and her prom. She underwent surgery to remove the lesion and biopsy her lymph nodes. 45 stitches and 19 staples later, “My arm looked like it had been bitten by a shark.” Two years, later a tiny freckle appeared at the site of the cancer. The melanoma was back, but a surgeon successfully removed it. Since then, Fraelick has undergone several biopsies to check other suspicious spots. To more closely track her many moles, her doctor is using a technology called mole mapping, which is available at many academic hospitals in the US, used for both for melanoma survivors and healthy patients who are at increased risk for developing the disease.
Employed in conjunction with other diagnostic methods, this technology can aid in catching melanoma early, when it’s most treatable, says James Grichnik, MD, Ph.D., professor and director of the melanoma program at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine. Dr. Grichnik is also a founder of Digital Derm, Inc., the manufacturer of MoleMapCD, a CD ROM-based imaging system that uses total body photography, 36 images in all, to create a “map” of the body.
The technology’s software allows MDs to zoom in on a particular mole to study it more closely and stores the images, to be used as needed during subsequent medical visits to check for potentially suspicious changes. “It’s a medical record that helps me determine if a mole is likely to be melanoma,” says Dr. Grichnik. “If I’m worried about a particular mole, I can see if it has increased in size or is new. The patients who are the best candidates for mole mapping are individuals with a large number of nevi (moles), particularly those that are atypical, or who have a family or personal history of melanoma.”
Atypical moles are larger than other moles or have “ABCD features:” asymmetry, border irregularity (such as scalloped or poorly defined edges), color that varies from one area to another, and a diameter greater than a pencil eraser, all of which can be warning signs of melanoma. Other possible symptoms include a mole that bleeds or oozes or is itchy, painful or sore. Also consult a doctor if you notice any skin mark that is new, unusual or changing in size, shape or color even if you don’t think it’s cancer. “Not all melanomas have the standard ABCD features,” adds Dr. Grichnik.
To check for melanoma (and other skin cancers), your doctor will do a thorough head-to-toe skin exam. “The best way to tell if a patient has melanoma is to look for a mole that doesn’t match the normal moles,” says Dr. Grichnik. If a suspicious spot is found, he examines it with a handheld microscope. “If we can’t conclusively say that it looks benign under the microscope, then we go to the mole mapping photos to see if the mole is new or changing. If it is, then we remove it for a biopsy.” With this three-step diagnostic process, he adds, “there’s a high likelihood we can catch melanoma early, before it becomes thicker and more dangerous.”
Would you get mole mapping?
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To learn more about melanoma diagnosis and treatment, visit the Sylvester Comprehensive Cancer Center website. For the skin cancer news and resources, go to MedlinePlus. Also, check out our blog post, “Indoor Tanning Linked to Skin Cancer Risk.” Heather Fraelick is now a volunteer for the Melanoma Foundation New England, a nonprofit dedicated to educating kids about sun safety and to helping patients cope with melanoma. The Environmental Protection Agency offers action steps to avoid overexposure to UV rays.
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