PracticalDermatology

Technology is changing the way that dermatologists evaluate patients and run their practices, and one of the missions of this Digital Practice column is to introduce readers to new technologies that have the potential to improve practice efficiency and patient care.

To that end, I spoke with Andrew Weinstein, MD, FAAD, a dermatologist in Boynton Beach, FL, about the Miiskin Pro app, which allows patients to document changes in moles and pigmented lesions over time using high-quality, longitudinal images that can be shared with dermatologists in the hopes of catching skin cancer earlier. (For the record, I have no financial interest in this technology.)

Tell us about the Miiskin Pro app.

Andrew Weinstein, MD, FAAD: Skin cancer is an epidemic, and monthly skin checks are one of the best methods for detecting suspicious changes to pigmented lesions early. Miiskin Pro allows a patient to easily capture high-quality photo diaries of individual lesions and wider skin areas. Miiskin uses augmented intelligence (AI) without decision making. The app enables the patient to accurately monitor skin and to avoid worrying about something that is not changing. It could potentially be used to monitor other skin diseases between appointments, as well.

What role does Miiskin Pro play in your practice?

Dr. Weinstein: Miiskin Pro has been tremendous in terms of following things and making sure that there isn’t a radical change in skin without us being alerted to that change. One of its great advantages is the fact that it is patient operated and patient controlled. It’s a great way for patients to record things that you want to be followed. If there is a change, your patient can notify you. If upon follow-up you determine it to be dangerous, you can take action. Importantly these photos give you context. When patients take a survey photo in Miiskin Pro, AI allows for each lesion in the field to be highlighted by a square. It brings your patient’s eye to that area so that he or she can see the individual lesion and the surrounding skin. It is much easier to see changes this way. It is simple. If a patient documents a change in Miiskin, he or she calls for an appointment.

Can it augment video appointments?

Dr. Weinstein: It doesn’t take the place of an in-person or video appointment. Video appointments have serious shortcomings. When a patient comes in to see us, we traditionally review their chief complaint, take a history, order lab studies, and conduct a physical exam. We put all of this together and make a differential diagnosis and develop a treatment plan. With a video appointment, you are missing much from a physical exam, so anything you can do to approximate this in-person exam, like a still picture, can enhance it. If a video appointment is your only option, using high-quality and reproducible still pictures that are taken by patients can be a game changer. Six months of survey pictures of the skin really enhances the quality of the video appointment.

Is there a learning curve for patients or providers?

Dr. Weinstein: I’m 54 and not the most technologically savvy person. I just took survey pictures of my own. This platform allows you to keep track of all lesions on your skin including those on your top, bottom, back, and front. The app verbally instructs you on where to stand after you prop your phone on a book or two. It then takes a series of full body shots. After that you can take as many close-ups as you like. It’s remarkable, and you can share photographs with your doctor in a HIPAA-compliant manner.

How can the app help with triage efforts?

Dr. Weinstein: If a patient has six months of pictures and it is clear that a lesion is growing, eroding, or changing in color, your decision is quite a bit easier. With that said, the best way to use this app and the information it provides is within the context of a normal dermatology visit. I advise all of my skin cancer patients to check their skin once a month, and this technology allows them to do so and to do it well. Patients can share the six-month catalog of photos at their follow-up appointment or they can prompt a visit earlier if they find something that is changing. The power of a tool like this is that it just uses augmented intelligence, not decision making, to get a better idea of what is going on. I offer a provider platform so my patients can access the app for free. Using the provider platform can also increase patient consultations through digital engagement.

For more information on the Miiskin Pro provider platform, visit miiskin.com/professionals/pro/.