Traditional self skin check
Traditionally, you can perform a head to toe skin check using a Mirror or your partner.
However, spotting subtle changes is impossible without a photograph. How will you know where the lesion is a year later? The rules themselves are flawed … and so on.
Use of a smartphone for skin cancer self checks
The smartphone is a great way to enhance your surveillance. Apps make tracking skin lesions easy. Smartphones with attached dermoscopy is now available for the consumer. All this makes it doubly-important that you seek advice.
It should be emphasised that the apps are not designed to diagnose skin cancer. Both the manufacturers of these apps and independent cancer experts such Terry Slevin, director of education and research at the Cancer Council of Western Australia, emphasise that they do not replace a visit to a doctor for a skin check.
What the apps and/or smartphone adapters can do is to flag up a lesion for further review by an expert.
The apps will typically allow you to do the following on your smartphone:
- Take a photo of a lesion.
- Map the lesion to body via a body diagram.
- Allow you to track the lesion over time.
- Provide a simple analysis of the lesion – absolutely not to be relied upon.
Adapters are coming onto the market that allow you to:
- Attach a dermoscopy lens to the smartphone.
- Take acceptable quality dermoscopy photographs of skin lesions.
- Forward the photographs to a doctor for analysis.
There are currently two main contenders for the combined smartphone dermoscopy with the app.
MoleScope is a smartphone adapter that is used with the MoleScope app.
Dermlite HUD is another system that provides similar functionalities.
How Can you tell if a mole is a melanoma?
Traditional self skin checks involve applying some simple rules to any concerning lesions that you see.
The ABCDE or SCAN rules are the best known.
These rules have quite significant shortcomings because they do not involve dermoscopy. However, they are better than nothing.
This acronym focuses on fewer characteristics of moles and is better at picking up non-melanomas. It is also a bit easier to remember.
Sore – Does the spot itch or is it sore? Has it taken more than 6 weeks to heal?
Changing – This is like “evolution” and the question is has it changed in size, color, or appearance?
Abnormal – Does the mole appear to be different from other moles you have? Just like the ugly duckling in the childhood story stood out from the rest of the flock, check for any growths that are not consistent with others in the area.
New – Did it just appear? While melanomas may evolve, they frequently appear as a new growth.
Other Warning Signs. Redness, pain, swelling, tenderness, bleeding, oozing or a scaly appearance can all be signs of skin cancer.
This acronym is to remind you what to look for when performing a skin cancer check. Each letter represents a certain characteristic you should use to evaluate each mole, growth, or freckle on your body. As you perform your check, ask these questions.
Asymmetry – Do both sides of the growth appear to be symmetrical? If one side does not look like the other, it may be cancer. Melanomas do not grow in a symmetrical fashion.
Border – Are the edges (border) irregular, notched or ragged in appearance? These are all warning signs of skin cancer.
Color – Is the color uniform or does it appear to have several colors? Does it have a mottled appearance? A harmless growth may be any of several different colors, but no matter the color, it is usually only one color.
Diameter – Is it greater than 6mm (1/4 of an inch)? Harmless growths are usually smaller than a pencil eraser.
Evolution – Has the mole or growth grown or changed in any manner since you last looked? If you see changes to color, size, symmetry or the edges, you need to immediately seek the services of a medical professional.
SCAN & ABCDE are designed mainly to screen for melanoma on the skin. Other changes to look for:
- A Brown or Black streak under the nail – particularly when this spreads to the nailfold can be a sign of nail melanoma
- A scar that appears waxy may be a rare type of BCC called a morpheaform BCC
- Look carefully at the edge of the lesion for any elevation. The elevation is called a “rolled edge” when part of a BCC. With a superficial BCC (A flat one), the rolled edge is subtle and best seen looking at an oblique angle.
- Look carefully at the reflectivity of a pink or red lesion. A BCC tends to be a little transparent or pearly/shiny whereas an IEC tends to be duller.
A new lesion that hasn’t healed within 6 weeks is an important sign that you need to get it checked out.