New free remote service helps with early diagnosis of suspect skin lesions

skin lesions
Australia has the world’s highest rate of melanoma with more than 13,200 new registrations and around 1770 Australians dying from this form of cancer every year. Photo by Jay Wennington on Unsplash

Worried about a dodgy-looking mole or other skin lesions, but you’re stuck in Covid lockdown or living in a remote area?

A new contactless service, designed by MoleMap, is now being used by melanographers in Australia and New Zealand to assess patient lesions remotely and refer high priority cases for further diagnosis and treatment during the pandemic.

The free virtual triage service, developed during COVID-19, has already identified skin cancer in 12% of high-risk patients examined, according to new figures.

Australia has the world’s highest rate of melanoma with more than 13,200 new registrations and around 1770 Australians dying from this form of cancer every year.

The data showed that for every 100 patients screened, 282 suspect lesions were imaged with dermatologists finding a total of 12 skin cancers, including eight melanomas, one of which was a nodular melanoma, the most serious form of skin cancer.

MoleMap, which has the world’s largest database of skin lesions, identifies around 400 new cases of melanoma each year in Australia and New Zealand.

Associate Professor and MoleMap dermatologist Helmut Schaider says that melanoma can progress quickly and it is critical to diagnose and treat early before the cancer cells enter the bloodstream.

He says while melanoma can be deadly, the prognosis for those identified at an early stage is usually very positive – with a 90% disease-specific five-year survival rate.

“We know from personal experience and literature that melanomas and non-melanoma skin cancers can develop within weeks,” says Professor Schaider.

“This is the reason why certain patients at high risk with a lot of moles, a personal or family history of skin cancer and those immunosuppressed are under constant surveillance and need ongoing care.

“Once the melanoma has progressed through the skin and into the bloodstream it can spread to other parts of the body where it becomes much harder to treat.”

Brisbane-based Professor Peter Soyer, also a MoleMap dermatologist, says new trial data has found virtual melanoma checks work well in collaboration with patient skin self examinations, with patients able to identify suspicious lesions with a high degree of accuracy.

He says the intuitive ability of patients to identify a lesion of concern is often the catalyst for them to seek further advice.

Professor Peter Soyer.

This early identification by patients is being made even more efficient with the advancement in teledermatology, which Professor Soyer says empowers patients to better manage their own health care outcomes.

“We are relatively fortunate that the mobility restrictions placed on patients during COVID-19 did not last longer than they did,” he says.

“When it comes to the initial identification of potential melanoma, research suggests patients are quite adept at recognising a change in their moles. At the same time this high level of self-awareness can lead to anxiety when there are delays in diagnosis – such as those experienced under COVID-19.”

Professor Soyer says that diagnosis through virtual imaging can be done with a high degree of confidence and is particularly well suited to those whose mobility is restricted or who live in rural areas with less health care infrastructure.

“Virtual identification of melanoma is paving the way for a new paradigm, which will help us develop new ways to treat patients remotely and will be an essential part of our preparation for the impact of future pandemics or a resurgence in this current one.”

Jodi Mitchell, MoleMap chairperson, says the new tech is an easy and inexpensive way to get a spot that concerns a patient evaluated by an experienced skin cancer nurse who can ensure that diagnosis and treatment of the most worrying lesions is prioritised.

She says the lockdown has accelerated their development of new virtual skin cancer diagnostic services and enabled MoleMap to offer patient solutions now provided in both a virtual and physical environment.

“We know that a large proportion of melanomas are initially identified by patients themselves and we are now able to use technology to help them have more direction over their care and treatment,” says Mitchell.

“For patients who have a melanoma, a delay in diagnosis can make a significant difference in treatment outcomes.

“Patients who are concerned about a lesion will soon be able to enter a portal which contains their records and initiate a video call with a specialist melanographer who can help them determine the next steps for treatment or immediately help relieve some of the anxiety they may be experiencing.

“The new triage service empowers the patient to make sure the lesion that is bothering them can be attended to. However, a full mole map offers a lot more; a full body skin examination — including the areas one can’t see oneself — image archiving of moles that might change in the future, and a dermatologist’s opinion on high-quality clinical and dermatoscopic images.”

Mitchell says globally telehealth and nurse led health care provision are on the rise and this sector in the past has been slow to adapt to the changing needs of consumers in the modern world.

“Despite skin cancer accounting for the largest number of cancers diagnosed in Australia we don’t have funded surveillance programmes in place to help stop the spread of this preventable disease. COVID-19 has provided us a real time opportunity to move towards a more patient centric treatment option which offers us a pathway to build a range of new services in the fight against skin cancer,” she says.