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Medical Edge Newspaper Column from Mayo Clinic

COMPLETE SKIN EXAM KEY TO DIAGNOSING MELANOMA

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 underway 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.

Additional Resources:
Treatment of Melanoma
Appointment Information
More Information on Melanoma

READERS: Before you head outdoors, slather on the sunscreen. The average adult requires one ounce of sunscreen — two tablespoons’ worth — for full body coverage. Apply 15 to 30 minutes before sun exposure and reapply every one to two hours while outdoors.

Here are some tips to select the right sunscreen. Look for one that offers:

— Broad-spectrum protection. Find one that protects against ultraviolet A (UVA) and ultraviolet B (UVB) sun rays. Both can damage the skin.

— SPF of 15 or higher. A sun protection factor (SPF) of 15 deflects about 93 percent of the UVB rays and allows you to remain in the sun 15 times longer than you normally would before getting burned. Higher SPFs deflect about 97 percent of the UVB rays.

— Water-resistant or waterproof qualities. This is especially important if you’ll be swimming or perspiring heavily. Water-resistant sunscreen protects for 40 minutes; waterproof sunscreen for up to 80 minutes.

— Skin-appropriate form. If your skin is dry, choose a cream or lotion sunscreen to increase moisture. For oily skin, choose an oil-free sunscreen. If you have sensitive skin, look for a sunscreen that contains only zinc oxide or titanium dioxide. These ingredients provide a physical barrier against UV rays rather than chemically absorbing them, which may be gentler on your skin. Avoid alcohol-based sunscreen if you have rosacea or eczema.

Additional Resources:
Sunscreen
More Information on Sunscreen

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.