Semi-automated total body photography supports robust delivery of skin cancer monitoring services during the SARS-COV2/COVID-19 pandemic.

BACKGROUND: The SARS-CoV-2/COVID-19 pandemic dramatically impacted the delivery of healthcare, including dermatological services. In the initial stages of the pandemic, reduced patient flow produced a dramatic drop in the volume of skin cancer screening. Consistent with COVID-19 precautions, our practice conducted visual skin examinations (VSE) utilizing semi-automated total body photography (TBP). METHODS: A cross-sectional study of patient characteristics and self-reported melanoma risk factors associated with TBP usage was conducted on all patients from May to November 2020 in a single practitioner private dermatology setting. The process and histopathology-confirmed outcomes were compared to those in the same 6-month period in 2019. RESULTS: For the May-November 2020 timeframe, those who opted for the home TBP (35%) compared to clinic TBP were younger, had higher self-reported skin cancer risk, and were more likely to have had previous TBP sessions. Overall, the number of TBP sessions increased, while dermoscopy usage and biopsy number decreased. There was no change in the number and distribution of skin cancer diagnoses compared to the same period in 2019. The Melanoma-In-Situ:Invasive Melanoma (MIS:INV) ratio was above the U.S. ratio reported for 2020 of 0.95:1 (95,710 MIS:100,350 INV). CONCLUSION: Semi-automated TBP was successfully implemented during the pandemic without affecting skin cancer detection.

Melanoma screening using patient self-assessed risk and total body photography.

The current standard of care for high-risk melanoma patients is a two-step process using Total Body Photography (TBP) followed by dermoscopy and is limited to a select group of patients. Methods: A cross-sectional study of patient characteristics and self-reported melanoma risk factors associated with TBP usage and pathology-confirmed outcomes was conducted on a sample of 4,692 patients in a single practitioner private dermatology setting. Results: TBP patients were significantly more likely to be male, partnered, tobacco users, highly educated, and have increased self-reported risk factors (such as fair skin, personal history of skin cancer or melanoma, family history of skin cancer, numerous moles, or previous history of sunburn, P<0.05). Personal history of skin cancer and melanoma, male gender, ?40 moles, Medicare insurance, and increasing age were positively associated with malignancy outcomes, whereas higher education, family history of melanoma, and traditional (private) insurance were associated with reduced prevalence of malignant lesions. Patients' self-assessed skin cancer risk and access to skin detection modalities can result in detection of melanoma at early, curable stages. Higher level of education and partner status may result in a greater awareness of risk factors associated with melanoma.