Detection of artificial changes in mole size by skin self-examination

Muhn, Channy; From, Lynn; Glied, Michelle

doi:10.1067/mjd.2000.104895

Cited by 30 publications

(27 citation statements)

References 19 publications

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“…Second, our study was focused on the best way to teach a direct morphological recognition of melanoma, but other useful indirect alert messages based on surveillance, i.e. ''a recent change'' or ''E'' criteria, 16 and comparison, i.e. the ''ugly duckling sign'' 17 could not be investigated in our study.…”

Section: Discussionmentioning

confidence: 99%

Superiority of a cognitive education with photographs over ABCD criteria in the education of the general population to the early detection of melanoma: A randomized study

Girardi

Gaudy

Gouvernet

et al. 2005

Intl Journal of Cancer

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Most education campaigns for melanoma (MM) detection in the general population have used the “ABCD” algorithm, although recognition of objects in the real life is based on a holistic image recognition rather than on analytic criteria. The objective was to compare analytic (ABCD) and cognitive (photographs) strategies for teaching self‐recognition of MM. A prospective 4‐arm stratified randomized trial in 255 individuals compared 3 realistic educative interventions by leaflets: 1) ABCD algorithm (“ABCD”), 2) a set of photographs chosen to stimulate recognition of MM among benign pigmented lesions (“Cog”), 3) photographs + explanations (“Cog‐Ex” arm) and 4) no intervention (“NI”). A 40‐slides test was performed before intervention (T0), 1 week after (T1) and after induction of anxiety (T2). In the “ABCD” arm, sensitivity slightly improved (80 to 83.8%, p = 0.04), but specificity dropped from 65.1 to 56.3% (p < 0.001), with no benefit in accuracy as compared to “NI”. In “Cog”arm, there was no change in sensitivity, but a strong increase in specificity (65.9 to 81.1%, p < 0.001) and accuracy (42.1 to 53.1%, p < 0.001). “Cog‐ex” resulted in similar although lower benefit. Under stress (T2), there was a dramatic loss of specificity and accuracy in “ABCD”arm (65.1 to 44.1%, p < 0.001 and 40.8% to 35.8%, p ≤ 0.001) without higher gain in sensitivity, while sensitivity and accuracy increased (p < 0.005) after “Cog” leaflet, without decreasing specificity. Finally, the “ABCD” message alone does not seem efficacious and is even worse in the context of anxiety, whereas a quick look at a few photographs is sufficient to improve the ability of the laymen to recognize a MM just by optimizing their spontaneous image recognition capacities. Education by photographs is a realistic strategy which should replace or complete “ABCD” message in the campaigns for self‐detection of MM. © 2005 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Superiority of a cognitive education with photographs over ABCD criteria in the education of the general population to the early detection of melanoma: A randomized study

Girardi

Gaudy

Gouvernet

et al. 2005

Intl Journal of Cancer

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“…A prospective study of the effectiveness of SSE is needed; however, the logistic constraints in conducting such a study are obvious. In a preliminary study by Muhn et al, 11 the efficacy of SSE to detect changes in mole size has been investigated in high-risk patients. 11 The specificity of SSE was 62% and the sensitivities of detecting 2-mm and 4-mm changes were 58% and 75%, respectively.…”

Section: Commentmentioning

confidence: 99%

“…In a preliminary study by Muhn et al, 11 the efficacy of SSE to detect changes in mole size has been investigated in high-risk patients. 11 The specificity of SSE was 62% and the sensitivities of detecting 2-mm and 4-mm changes were 58% and 75%, respectively. In a recent study by Dawid et al, 12 the ability of patients to identify real changes in melanocytic nevi was evaluated in 251 patients with 1431 melanocytic nevi.…”

Section: Commentmentioning

confidence: 99%

“…[7][8][9] Results suggest that SSE is associated with a reduced risk of melanoma, and it is a moderately effective tool for detecting changes in mole size. [10][11][12] During the past decades, atypical nevi (dysplastic nevi) have been identified as the strongest indicators of melanoma risk. [13][14][15][16][17][18] The presence of large numbers of clinically atypical nevi hinders selfexamination and professional evaluation.…”

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confidence: 99%

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Diagnostic Accuracy of Patients in Performing Skin Self-examination and the Impact of Photography

Oliveria

Chau²,

Christos³

et al. 2004

Arch Dermatol

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To determine the sensitivity and specificity of skin self-examination (SSE) to detect new and changing moles with and without the aid of baseline digital photographs in patients with dysplastic nevi.Design and Intervention: Patients had baseline digital photography and mole counts of their back, chest, and abdomen and were instructed to perform a baseline SSE. Print copies of the images were provided to the patient. Following the baseline examination, the appearance of existing moles was altered and new moles were created using cosmetic eyeliner. The number of moles altered and/or created totaled approximately 10% of each patients' absolute mole count.

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“…Most studies contributing to the evidence for SSE are small, use a non-randomised pre-post study design or test accuracy of detecting change in skin lesions which are artificially enlarged [9]. In the study by Muhn et al [11], artificial change was examined by artificially increasing mole size on participants’ backs, and then they were asked to detect any increases in size. Key studies on the role that technology could play in enhancing SSE show consumers recognise melanoma better from dermoscopic images than from clinical photographs [12].…”

Section: Introductionmentioning

confidence: 99%

Redesigning Skin Cancer Early Detection and Care Using a New Mobile Health Application: Protocol of the SKIN Research Project, a Randomised Controlled Trial

et al. 2018

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Patients often detect melanoma themselves; therefore, regular skin self-examinations (SSEs) play an important role in the early detection and prompt treatment of melanoma. Mobile teledermoscopy is a technology that may facilitate consumer SSEs and rapid communication with a dermatologist. This paper describes the planned randomised controlled trial of an intervention to determine whether mobile technologies can help improve the precision of SSE in consumers. A randomised controlled trial will be conducted to evaluate mobile teledermoscopy-enhanced SSE versus naked-eye SSE. Participants in each group will conduct three home whole-body SSEs at baseline, 1 and 2 months, then present for a clinical skin examination (CSE) by a doctor after the 2-month SSE. Specifically, participants will identify skin lesions that meet the AC (asymmetry and colour) rule for detecting a suspicious skin spot. The primary outcomes are sensitivity and specificity of the skin lesions selected by the participants as needing attention by a doctor, compared to the clinical diagnosis by the dermatologist that will serve as the reference standard for this analysis. For the mobile teledermoscopy-enhanced SSE group, researchers will assess the number, location and type of lesions (1) sent by the participant via mobile teledermoscopy, (2) found at CSE or (3) missed by the participant. For the naked-eye SSE group, researchers will assess the number, location and type of lesions (1) recorded on their body chart by the participant, (2) found at CSE or (3) missed by the participant. Secondary outcomes are based on participants’ self-reported data via online questionnaires.

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Detection of artificial changes in mole size by skin self-examination

Cited by 30 publications

References 19 publications

Superiority of a cognitive education with photographs over ABCD criteria in the education of the general population to the early detection of melanoma: A randomized study

Superiority of a cognitive education with photographs over ABCD criteria in the education of the general population to the early detection of melanoma: A randomized study

Diagnostic Accuracy of Patients in Performing Skin Self-examination and the Impact of Photography

Redesigning Skin Cancer Early Detection and Care Using a New Mobile Health Application: Protocol of the SKIN Research Project, a Randomised Controlled Trial

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