What Is the Main Idea?
This post was inspired by the open access research article “The Additive Value of 3D Total Body Imaging for Sequential Monitoring of Skin Lesions: A Case Series” published in the journal Dermatology. The article focuses on the benefits of a recently introduced dermatological technique called 3D total body photography. This blog post describes the conclusions of the article in the context of diagnosing melanoma.
What Else Can You Learn?
This post also gives the risk factors for melanoma and discusses why timely diagnosis is essential but can be challenging. It recommends being actively involved in monitoring your skin health.
What Is Melanoma?
Melanoma is a type of skin cancer that develops in the melanocytes, which are the cells that produce the skin pigment melanin. They are located in the bottom layer of the skin’s epidermis (the outermost layer of the skin). The melanin they produce plays a role in protecting the hypodermis (also known as the subcutaneous tissue) from the damaging effects of ultraviolet radiation. Melanocytes are also part of the immune system.
The risk factors for melanoma are:
- Excessive exposure to ultraviolet radiation, including from sunlight and tanning beds.
- A family history of melanoma.
- Having a large number of moles, unusually shaped moles, fair skin, or a tendency to sunburn.
- Being immunocompromised.
Although the greatest risk of melanoma is related to the damage from ultraviolet radiation, it can develop on any part of the skin, including those that don’t get much sun. Melanoma has also been found on the eyes, nose, and throat, although these are very rare cases.
The Challenge of Timely Diagnosis of Melanoma
Melanoma is the second most common cancer in adults aged 25 to 49 and its incidence in people under 40 is increasing. It is considered the most serious form of skin cancer. Early treatment is essential to control its spread. If it is detected and treated early, it is usually curable, with a five-year survival rate in the US of 99%. However, if it metastasizes to other parts of the skin or deeper into the body, this survival rate drops significantly.
Regular skin monitoring is the key to detecting any malignancies of the skin, including melanoma. Short-term digital dermoscopy at regular intervals (e.g., once every three months) is the current method applied to moles and other lesions that arouse suspicion. In the longer term, dermoscopy is performed every 6 to 12 months, with the goal of identifying certain changes that might indicate the onset of melanoma. These techniques are successful in detecting melanoma and in avoiding unnecessary surgical intervention (e.g., the removal of benign moles).
However, there is a certain flaw in these approaches. Dermoscopy is time-consuming and is thus generally only applied to known potential issues — moles, lesions and so on. This ignores the rest of the skin, and melanoma can develop from skin with no existing issues. It is essential to have techniques that cover the whole body but are not as time-intensive as traditional dermoscopy or even 2D total body imaging combines with digital dermoscopy.
How 3D Total Body Photography Helps Overcome These Limitations
With 3D total body photography, 92 images of the patient’s body are captured simultaneously and assembled digitally to give a picture of almost the entire surface of the skin. This recently introduced technique is better at imaging curved surfaces. It also makes it much easier to compare images of any part of the body over time, as the images can be compared side-by-side onscreen. Software has been designed to support clinicians working with the images, for example facilitating the linking of an area of the whole-body image to a dermoscopy image of a lesion.
In the research article “The Additive Value of 3D Total Body Imaging for Sequential Monitoring of Skin Lesions: A Case Series”, the authors looked at three case studies to highlight the benefits of using 3D total body photography alongside traditional methods. They identify how helpful it is in the surveillance of skin lesions, particularly when patients have multiple lesions or moles of concern. They also point out the value in identifying issues in areas of skin that were not previously areas of concern.
The cases selected for the paper were chosen by the authors as they have educational value and illustrate the value of longitudinal 3D total body photography alongside other techniques. Based on their experience with the technique, they also suggest that further development of the technology may come in the form of better resolution in the photographs and software-aided analyses of the images.
Should I Ask My Doctor about 3D Total Body Photography?
If you are worried about melanoma, you should regularly see a dermatologist and/or talk to your general practitioner about your concerns. As mentioned, melanoma is dangerous and must be diagnosed and treated early. If you have any of the risk factors listed above, this is all the more reason to have a professional assessment of your skin on a regular basis.
Since it has been shown that 3D total body photography supports the diagnosis of melanoma and other skin malignancies, it’s worth mentioning the technique to your dermatologist and general practitioner. They may be interested in the paper and they may also have experience with the technique or know of a clinic or hospital that practices it. Taking an active role in monitoring your skin health is in your best interest.
Note: One of the authors of the paper declared that they are a shareholder and consultant for two dermatological companies, a consultant for a third, and an advisor for a fourth. It is normal for authors to declare this in case it might be perceived as a conflict of interest. For more detail, see the Conflict of Interest Statement at the end of the paper.