Currents: The Picture Issue

Could Teledermoscopy Speed Time to Case Resolution in Skin Cancer?

Teledermatology for skin cancer referral and triage would add to the costs of care but would result in more rapid clinical resolution—at least in Australia. Findings from a study, published in JAMA Dermatology, show that the average additional cost per case was $55, but cases were resolved 26 days sooner.

To assess the cost-effectiveness of teledermoscopy as a referral mechanism for skin cancer diagnosis and management in Australia, researchers undertook a Cost-effectiveness analysis using a decision-analytic model of Australian primary care, informed by publicly available data.

They compared the costs of teledermoscopy referral (electronic referral containing digital dermoscopic images) vs usual care (a written referral letter) for specialist dermatologist review of a suspected skin cancer.

Findings from the decision-analytic model showed that the mean time to clinical resolution was nine days with teledermoscopy referral compared with 35 days with usual care alone. Get more on Teledermatology’s promise here.

New AAD PSA—Protect Yourselfie—Highlights Dangers of Tanning

A new public service advertisement from the American Academy of Dermatology (AAD) makes a visual appeal to encourage those who are thinking of tanning to think again.

Released in conjunction with Skin Cancer Awareness Month in May, the new AAD PSA “Protect Yourselfie” uses social media imagery to remind teenage girls that tanning could lead to skin cancer and premature aging and encourages them to protect their skin from harmful ultraviolet rays (protectyourselfie.com). Melanoma is the second most common cancer in young women ages 15-29, and research suggests that the majority of melanoma cases are attributable to UV exposure from the sun and indoor tanning beds.

The AAD also used Skin Cancer Awareness Month to recognize “Skin Cancer Heroes”—patients and survivors, the friends and loved ones who have helped and supported them, and the board-certified dermatologists who have detected and treated their skin cancer. The AAD encourages everyone, including young women, to be their own Skin Cancer Heroes by taking steps to prevent skin cancer: staying out of indoor tanning beds, and protecting themselves from the sun by seeking shade, wearing protective clothing, and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.

Skin Cancer Survey Spotlights Patient Frustrations; Need for Resources

People living with skin cancer struggle with perceptions that their condition is less serious than other types of cancer despite significant physical and emotional impact, according to Skin Cancer In America 2018, a national survey by Health Union, LLC of people diagnosed with the condition.

WATCH IT NOW

Improve The Quality of Your Before and After Photos

Todd Schlesinger, MD and DermTube Journal Club co-host Nancy Samolitis, MD discuss simple strategies to improve medical photography in a dermatology practice. From choosing the best cameras to setting up standardized backgrounds, Dr. Schlesinger shares details about how his office is set up to get the best medical dermatology photographs, and briefly discusses issues to think about for cosmetic dermatology before and afters. He also offers tips for organizing, storing, and sharing photographs among multiple providers in a single practice.

Watch now at dermtube.com/series/dermjournalclub

One respondent expressed being “shocked and disheartened” by people who think skin cancer can simply be “zapped off at the dermatologist’s office” and, as a result, having “my cancer downplayed.” The reality is that more people are diagnosed with skin cancer in the US each year than all other cancers combined, according to the American Cancer Society. And, almost 100 percent of Skin Cancer in America respondents said they had a surgical procedure, such as excision or Mohs surgery, for their skin cancer.

Recurrence concerns add to the painful reality, with more than half of respondents thinking about recurrence daily or a few times per week. And the need for frequent monitoring also contributes heavily to the often overlooked emotional impact of skin cancer. Almost three-quarters of respondents said they had skin checks or were monitored at least twice a year. One respondent described the biopsies and tests as “scary and painful,” saying they “hurt and leave scars.”

Concerns about skin checks and other monitoring appointments are particularly significant among those with melanoma. More than 80 percent of melanoma patients getting skin biopsies reported either “more anxiety” or “a lot more anxiety than normal.” Additionally, 34 percent of respondents with melanoma reported “a lot more anxiety than normal” due to scans, higher than those with squamous cell carcinoma (19 percent) and basal cell carcinoma (18 percent).

Skin cancer also has a significant impact on the physical, social, and emotional well-being of respondents, on par with the effects of people living with other forms of cancer. More than 60 percent of respondents said they worry about dying at least “a little bit,” and 64 percent said they feel at least “a little bit” sad and nervous. More than a fifth of respondents said they had a “more negative” or “much more negative” outlook on life since their diagnosis.

The resources that people with skin cancer seek out are unique to the external and visible nature of the condition. In addition to research topics prevalent across different types of cancer – like new treatments—nearly half of respondents said they seek out information about sun protection and 40 percent look for photos of different types of skin cancer. Searching for photos is even more prominent—47 percent—among those with basal cell carcinoma.

“We found very early on that sharing photos is an important aspect of the patient journey for our SkinCancer.net community and, as a result, have facilitated more opportunities to do so,” said Tim Armand, Health Union president and co-founder. “In addition to providing useful information, photo sharing serves as a powerful and very human way to connect with others living with a condition that is erroneously viewed as less impactful than other forms of cancer.”

Skin Cancer in America surveyed 805 US respondents living with skin cancer from Jan. 23 to March 21, 2018.

Psoriatic Arthritis Awareness Project Launches: Films and Images Highlight Importance of Treatments

The National Psoriasis Foundation (NPF), in collaboration with Novartis Pharmaceuticals Corporation, premiered the Psoriatic Arthritis (PsA) Awareness Project. The PsA Awareness Project is a set of patient films that highlight the importance of treating PsA and receiving optimal care. Patients featured in the films were nominated and selected by the PsA community. Film ideas were generated with the help of Tongal—a global creator network of filmmakers, including writers, directors, and producers. A panel of judges from the PsA community chose the winning creative concepts and filmmakers for the project.

The films, as well as behind the scenes footage and film trailers, are available for viewing on the NPF website at psoriasis.org.

The films feature stories from Jennifer Pellegrin and Shirley Wallace, uncovering details of their PsA diagnosis and how they live their lives despite having the disease. Throughout the creative process of choosing, planning and shooting the films, the aim was to take an innovative and intimate approach that would bring these stories to life and resonate with others living with psoriatic arthritis.

“We are excited to release these films during Psoriatic Arthritis Action Month, as the theme is ‘Live, Work, and Play with PsA,” said Leah Howard, JD, chief operating officer, NPF. “There is no better way to drive awareness and support others living with PsA than to work with the psoriatic disease community and share stories that create real connections among those living with PsA.”