“I thought I could beat anything. Then my doctor said: ‘You have skin cancer’ Melanoma is not the most common of skin cancers, but it is the most dangerous if not found in the early stages.”Jane Green, Author
Skin cancer is one of the most common cancer types worldwide: one in five people in the U.S. is expected to receive a skin cancer diagnosis. Early detection and treatment are invaluable: almost all skin cancers (both melanoma and nonmelanoma) can be cured if found and treated early. The American Cancer Society reports that across all stages of melanoma, the average five-year survival rate in the U.S. is 92%. The estimated five-year survival rate for patients whose melanoma is detected early is 98%. Prevention and detection are the key. One of the impacts of the COVID-19 pandemic has been a decrease in the number of patients visiting dermatologists to check for suspicious moles or changes in their skin. One fact dermatologists pointed out in a recent survey was that about 21% of melanomas might have gone undetected in 2020.
The annual cost of treating skin cancers there is estimated at $8.1 billion: about $4.8 billion for non-melanoma skin cancers and $3.3 billion for melanoma, which is a huge number. Fortunately, digital technologies are on their way to help dermatologists diagnose and treat skin diseases better and more effectively. After reviewing the current research on the topic, here are the key technologies that will help support the practice of dermatology in the coming years.
Teledermatology – Smartphones coupled with super-fast internet connections make it easy to send pictures or footage anywhere, so telehealth solutions appeared naturally in dermatology. The options of teledermatology services, as well as self-care platforms, are soaring. Companies like FirstDerm, Direct Dermatology, iDoc24, and SkinVision all work based on the same principle: they promise patients the option to self-check their symptoms and connect to a dermatologist online for consultation within a very short time. Usually, people can load up their photos to a particular platform, and smart algorithms and/or dermatologists give advice based on them. COVID-19 has given rise to telemedicine practices across the entire healthcare industry, but dermatology has been one of the easiest to adapt to the digital age. As the Journal of the American Academy of Dermatology” puts it, COVID-19 has removed “many restrictions that have roadblocked telehealth adoption.” There has historically been an immense shortage of dermatologists in the U.S. A 2017 estimate found that there were only 3.4 dermatologists per 100,000 people nationwide, and the average wait time to see one of them is 32.3 days. Even with all the obvious checks in the “pro” column—affordability, convenience, and accessibility—teledermatology still isn’t perfect. So, it’s essential to understand what conditions are best treated with teledermatology and which require an in-person visit.
Primary Care Physician Office – The DermaSensor is a handheld objective skin cancer sensing device that utilizes both pulses and light and spectroscopy to non-invasively identify information about a skin lesion at the subcellular level. More specifically, this device uses Elastic Scattering Spectroscopy (ESS), which measures and records photon scattering patterns as they reflect off different cellular structures following the input of quick bursts of light. ESS technology has been validated in more than 30 clinical publications that have demonstrated this technique’s utility in analyzing the macroscopic structure of both cellular and subcellular particles. Since malignant lesions scatter light at different intensities, the DermaSensor algorithm, derived from thousands of spectral samples of pathologically verified lesions, will immediately categorize a skin lesion as “Higher Risk” or “Lower Risk.” The DermaSensor device is intended to be used by primary care physicians in annual patient visits to check for suspicious skin lesions or changes in the skin since the last visit. PCPs will be able to use DermaSensor™ as an adjunctive tool to assess skin lesions better and determine whether an additional evaluation is needed.
High-resolution, whole-body imaging – Explicitly designed for dermatology, the VECTRA WB360 whole-body 3D imaging system from Canfield Scientific captures the entire skin surface in macro quality resolution with a single capture. The fully integrated software allows clinicians to map and monitor pigmented lesions and distributed skin diseases. Other applications include documenting pigmented lesions, psoriasis, and vitiligo.
Wearable sensors – The clip-on QSun can detect UV exposure using five LED displays to indicate UV index. Once you shake it, it’ll let you know your UV index. That’s your measurement of how powerful ultraviolet radiation beaming from the sun is. The iOS and Android-friendly wearable keeps track of how long you have been out in the sun before you start to burn. When your time is up, it’ll vibrate to let you know that you should get in the shade. The QSun’s AI considers skin type to help determine the time that should be spent out in the sun. The Shade disc-shaped device is packed with sensors that can measure UVA and UVB rays and are even sensitive enough to do that with indoor light. The iOS and Android compatible wearable uses a magnetic clasp to wear on pretty much any piece of clothing, and it’ll keep you protected for five days before you need to power it up. If you like your wearables invisible, LogicInk will keep you safe in the sun with its Logic UV temporary tattoo. You stick the tat to your skin and watch its two rings throughout the day. There’s no phone or smartwatch involved. Simply keep your eyes on the tattoos. The smaller inner ring tells you how harsh the sun is by changing from white to purple. The outer, larger ring will turn bright pink from purple when you’re getting close to burning your skin.
The dermatology app environment – Over the past few years, developers have created smartphone apps that help users monitor moles and lesions for any signs of progression to skin cancer. Popular apps include the following:
- UMSkinCheck – The University of Michigan launched a free app that guides users through a complete home skin check exam. This app also offers the opportunity to create a mole library. This will enable people to compare and track any skin changes over time.
- MoleMapper – The Oregon Health & Science University developed this app. It allows users to take photos and gather measurements of any moles on their bodies. Similar to UMSkinCheck, the app will enable users to take regular pictures of their moles to facilitate change tracking over time.
- Miiskin – This app also allows users to take pictures to track their moles over time. Users can also pay for a version that lets them track large areas of skin. This may help them identify new marks and moles they might not have seen.
- MoleScope – This is a high-resolution camera compatible with many different smartphones. This camera uses high magnification and special lighting to take more detailed and better quality photos than other skin cancer apps. It also contains many features that other apps do, such as skin mapping, image management, and regular reminders.
- SkinVision – This app helps users identify high-risk moles that require further testing. The app classes each photo as either high or low risk. SkinVision also provides advice on the next steps to take.
- Cureskin – The artificial intelligence-based app was developed by two engineers previously working by Google, and it aims to compensate for the lack of dermatologists in India. It can diagnose six common skin conditions – pimples, acne, scars, dark spots, pigmentation, and dark circles. The user takes a photo, the algorithm analyses the skin issues, the app’s chatbot asks a few questions, and, depending on the inputs, the A.I. recommends an eight-week skincare regimen.
- Dermatology A to Z – The American Academy of Dermatology developed the Dermatology A to Z, specifically designed to serve consumers looking for skin health information. The app gives users evidence-based, dermatologist-approved health information, insights on diseases affecting skin, hair, and nails, and the latest medical and cosmetic treatments. Utilizing the smartphone’s GPS tracking system, the app can show the UV Index in real-time to fight against the dangers of ultraviolet radiation and find the nearest dermatologist in the area.
- Eczema Tracker – Through the app, users can check pollen, mold, temperature, and humidity levels for any location, track the flare-up of eczema and get valuable advice on how to control and manage the condition for all ages. Through constant monitoring, patients have the chance to follow what triggers their symptoms and whether their medication can alleviate them.
But are these apps accurate? Although the developers of some of these apps claim that they identify problematic moles and lesions accurately, research has shown that this might not be the case. A 2019 article in Trusted Source in the BMJ found several downsides to the available skin cancer apps, including a lack of testing to verify their effectiveness, a shortage of expert input when developing the technology, and issues with the technology itself. More scientific research will help doctors more clearly determine the accuracy of these apps. There are, however, some significant benefits to the regular reminders and the ability to photographically track moles or skin changes. For example, many people do not regularly check their skin. It can also be challenging to remember what a mole looked like last month or six months ago. Apps can provide valuable information to support advice from a doctor.
Where we’re going – Using advanced technologies to reduce the number of skin cancer issues could be crucial in pushing back the disease. Perceived value, trustworthiness, privacy, design, and costs are important barriers and facilitators regarding the use of mobile health applications (mHealth apps) for skin cancer screening, according to study findings published in the British Journal of Dermatology.