Doctor, is this “mole” anything to worry about? Rural Track Dermoscopy Workshop DeWayne Niebur MD Mark Deutchman MD

Skin problems are common and a frequent cause for visits. Number of U.S. office visits: 1.0 billion Number of visits per 100 persons: 332.2 Percent of visits made to primary care physicians: 55.5% Skin problems are in the top 10 reasons for office visits http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf

Office visit diagnoses

Skin meds are 11th most commonly used http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf

Skin cancer – the most common kind of cancer Basal cell and squamous cell Melanoma Merkel cell carcinoma Lymphomas of the skin Kaposi’s sarcoma http://www.cancer.org/cancer/skincancer/index?cancerTypeRedirect=/Cancer/index

The ABCDE’s of pigmented lesions A = asymmetry B = borders C = color D = diameter E = evolving

Asymmetry http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes#panel1-1

Border irregularity http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes#panel1-1

Color variation http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes#panel1-1

Diameter > 6mm (pencil eraser) http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes#panel1-1

Evolving http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes#panel1-1

Can we do better with dermoscopy? Magnifies and illuminates skin features Brings subsurface structures into view Helps differentiate benign from cancerous: Melanocytic V. non-melanocytic Nevi from melanomas

Dermoscope Light source Magnifier Non-polarized require direct skin contact with gel interface Polarized does not require direct skin contact

Dr. Niebur’s story