Take 5: Developments Toward Improved Skin Cancer Detection and Treatment

1. Computer System Effective at Detecting Melanoma. New evidence suggests that MelaFind, a computer-vision system that uses 10 different wavelengths to see up to 2.5mm beneath the skin's surface, is a safe and effective tool in the evaluation of pigmented skin lesions. Researchers used standard images and patient information for a subset of 50 randomly selected lesions (25 melanomas) in a study of 39 independent dermatologists to estimate clinicians' sensitivity to melanoma. They found that the measured sensitivity of MelaFind was 98.4 percent, compared to 78 percent in the dermatologist group. Including borderline lesions (high-grade dysplastic nevi, atypical melanocytic proliferations, or hyperplasias), MelaFind's sensitivity was 98.3 percent, with a biopsy ratio of 7.6:1. Finally, on lesions biopsied mostly to rule out melanoma, MelaFind's average specificity (9.9 percent) was superior to that of clinicians (3.7 percent). (Archives of Dermatology. Epub.)

2. Older Men Not Likely to Screen for Skin Cancer.
New evidence indicates that men over the age of 50, the group at highest risk for skin cancer, comprise a relatively small percentage of those seeking skin cancer screening. Of the 487 individuals who sought screening over a six month period, only 26.8 percent were men over the age of 50. Twenty percent of patients seeking screening were at very low risk based on their age and history. Almost two thirds of participants were women, and the median age was 53. (Archives of Dermatology. 1246: 1097-1102)

3. Screeners See Early Detection as Important.
The most frequently cited reasons for seeking screening were family history of skin cancer and worries about exposure to the sun, the same study revealed. Interestingly, younger patients were more likely to seek screening on the advice of a friend, while those who were older chose to be screened because of previous skin cancer. About 90 percent of patients indicated that they considered skin cancer screening to be as important as colonoscopy, mammograms, and Pap smears in preventing cancer deaths.

4. Imaging May Assist PDT.
A technique known as spatial frequency domain imaging uses LED lights of various colors to produce spatially resolved maps of the optical properties of skin cancer lesions, tissue oxygenation, and quantitative distribution of topically applied photosensitizing drugs. The process takes five to 10 seconds and may allow for optimized PDT and confirmation of efficacy. The next step will be to enable the therapeutic aspects of the instrument to monitor the tissue dynamics during PDT treatment regimens. researchers say. Results were presented at Frontiers in Optics 2010.

5. High Photoprotection = Low Vitamin D?
A new study links increased photoprotection to low vitamin D levels. In the study, researchers noted that patients with basal cell nevus syndrome, which increases the risk of skin cancer, had a threefold greater prevalence of vitamin D deficiency compared to the general population. The assumption is that careful UV avoidance by these patients contributes to low vitamin D levels. (Archives of Dermatology. 146: 1105-1110)