MEL-SELF Analysis: Comparable Outcomes Between Affordable and Premium Dermatoscopes
Key Takeaways
A new analysis shows both high- and low-cost dermatoscopes enabled patients to capture images sufficient for review by a teledermatologist.
The polarized device produced slightly higher image quality, but at increased cost.
Usability ratings were similar between groups.
A new randomized study embedded within the MEL-SELF trial suggests both low-cost and high-cost dermatoscopes enabled patients with a history of early-stage melanoma to effectively capture images for remote dermatologic assessment.
The paper by Ackermann et al, published in JAMA Dermatology, looked at lower-cost, ambient-light, nonpolarized dermatoscope and compared it to a more expensive, illuminated, polarized device in a cohort of 251 Australian adults previously treated for stage 0-II melanoma.
Participants were randomized (1:1) to receive either device and submitted lesion images via a secure teledermatology platform every 3 months over 12 months. The proportion of participants submitting baseline images of sufficient quality to support a teledermatologist’s management recommendation was selected as the primary study outcome.
A recommendation was provided for baseline images in 71.9% of participants using the polarized device and 67.5% using the ambient-light device—a non-significant difference. Image-level analysis favored the polarized device: 95.0% of images from the polarized group were deemed reportable vs 91.1% from the ambient-light group (difference of 3.9%; 95% CI, 1.5% to 6.3%). Teledermatologists also reported more image quality problems like blurriness and poor lighting—among images taken with the ambient-light device.
The polarized dermatoscope came at nearly ten times the cost ($324.16 vs $35.40). Patient usability ratings were similar between groups.
“In this SWAT, a lower-cost, ambient-light, nonpolarized dermatoscope and a higher-cost, polarized dermatoscope enabled patient-performed teledermoscopy," the authors wrote. "Decisions to adopt a particular device should consider not only image quality but also costs, user training requirements, and implementation feasibility.”
Source: Ackermann D, et al. JAMA Dermatology. 2025. Doi:10.1001/jamadermatol.2025.4792