MAUI, HAWAII — If dermoscopy and total body photography for early detection of melanoma aren't now the clinical and legal standard of care in dermatology, they're awfully close, Dr. Allan C. Halpern said at the annual Hawaii Dermatology seminar sponsored by Skin Disease Education Foundation.
There is compelling evidence that total body photography (TBP) aids in identifying skin lesions of concern while dermoscopy helps in further evaluating them, said Dr. Halpern, chief of the dermatology service at Memorial Sloan-Kettering Cancer Center, New York.
TBP permits detection of subtle melanomas that lack the classic clinical features. This year, the Center for Medicare and Medicaid Services allowed reimbursement for TBP.
In one meta-analysis, dermoscopy resulted in a marked improvement in diagnostic accuracy. Naked-eye clinical examination of lesions by experienced physicians had only a middling 70% sensitivity and 75% specificity for diagnosis of melanoma. This rose to 83% and 86%, respectively, with dermoscopy (Arch. Dermatol. 2001;137:1343–50).
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