Case and Research Letters
Skin Self-examination Using Smartphone Photography to Improve the Early Diagnosis of Melanoma
Autocontrol fotográfico mediante smartphones para mejorar el diagnóstico precoz del melanoma
S. Vañó-Galván
, J. Paoli, L. Ríos-Buceta, P. Jaén
Autor para correspondencia
Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain
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Vañó-Galván, J. Paoli, L. Ríos-Buceta, P. Jaén" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Vañó-Galván" "email" => array:1 [ 0 => "sergiovano@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Paoli" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Ríos-Buceta" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Jaén" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Autocontrol fotográfico mediante <span class="elsevierStyleItalic">smartphones</span> para mejorar el diagnóstico precoz del melanoma" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1515 "Ancho" => 1000 "Tamanyo" => 141578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">General design of the smartphone application FotoSkin<span class="elsevierStyleSup">®</span>.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Patient skin self-examination has proven to be very useful in the secondary prevention of melanoma.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> Various studies show that campaigns to raise awareness and to encourage skin self-examination make it possible to diagnose thinner melanomas, thus improving prognosis.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Self-examination can be optimized by taking photographs according to a specific protocol.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This photographic record facilitates identification of new lesions and reveals significant changes in existing ones. An additional advantage of photographic self-examination systems is that they improve patient adherence and accuracy in self-examination.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Other useful measures in photographic self-examination include comparison of photographs against mole mapping diagrams<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and visual images of benign and malignant lesions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">At present, photographic self-examination by patients aimed at secondary prevention of melanoma is not a habitual practice,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> even though it has proven to be effective.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> The reasons for this observation include ignorance of the importance of photographic surveillance, the inconvenience of taking photographs with a camera from which the images then have to be downloaded and stored on a computer, and the lack of adherence to self-examination due to forgetfulness.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We present a technology-based solution to foster patient self-examination, namely, an application for smartphones (FotoSkin®) that enables patients to take regular photographs of their skin according to a specific protocol (mole mapping). These photographs can then be taken to the clinic in order to provide the dermatologist with a more accurate picture of how moles and other types of skin lesions are evolving (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The application also includes 3 sections aimed at improving patients’ knowledge of skin cancer, raising awareness, and, therefore, promoting adherence to self-examination and visits to the dermatologist. The sections are the following: 1) an information section showing the patient the differences between benign lesions and suspicious or malignant lesions; 2) a section with algorithms to determine the phototype, risk of melanoma, and level of actinic damage; and 3) a dynamic section showing the local UV index and providing practical advice on photoprotective measures and healthy sun exposure.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The main objective of FotoSkin® is to act as a photographic record of the patient's moles and other skin lesions that can later be shown to the dermatologist at checkups (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Visualization of changes in the lesions thus improves the dermatologist's diagnostic accuracy and even improves secondary prevention of the melanoma by enabling the patient to see whether the lesions are new or have changed,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as well as encouraging the patient to adhere to self-examination and checkups. The secondary objective of FotoSkin® is to improve health education about melanoma, skin cancer, and healthy sun exposure habits.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The application was designed for smartphones and tablets, both of which have several advantages over a computer,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> namely, ease of use, rapid photographs and storage, automatic reminders about self-examinations, and, in particular, portability (patients can take their photographs with them when they visit the dermatologist). FotoSkin® is free to download and use and is available for iOS (iPhone, iPad) and for Android.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, new technology can help to improve skin self-examination in secondary skin cancer prevention by means of systematized whole-body photographic mapping, reminders, and visits to the dermatologist. It can also help to improve health education and encourage patients to become actively involved in the care and surveillance of their skin.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">The FotoSkin® application was funded by ISDIN. However, ISDIN did not participate in the preparation of the content included in the application.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vañó-Galván S. Autocontrol fotográfico mediante <span class="elsevierStyleItalic">smartphones</span> para mejorar el diagnóstico precoz del melanoma. Actas Dermosifiliogr. 2015;106:75–77.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1515 "Ancho" => 1000 "Tamanyo" => 141578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">General design of the smartphone application FotoSkin<span class="elsevierStyleSup">®</span>.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1894 "Ancho" => 900 "Tamanyo" => 154211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Patient self-examination screen.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy of patients in performing skin self-examination and the impact of photography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 7 | 16 |
| 2024 Octubre | 73 | 40 | 113 |
| 2024 Septiembre | 92 | 29 | 121 |
| 2024 Agosto | 114 | 76 | 190 |
| 2024 Julio | 81 | 27 | 108 |
| 2024 Junio | 82 | 30 | 112 |
| 2024 Mayo | 75 | 29 | 104 |
| 2024 Abril | 73 | 22 | 95 |
| 2024 Marzo | 70 | 29 | 99 |
| 2024 Febrero | 79 | 29 | 108 |
| 2024 Enero | 52 | 32 | 84 |
| 2023 Diciembre | 58 | 21 | 79 |
| 2023 Noviembre | 62 | 31 | 93 |
| 2023 Octubre | 57 | 36 | 93 |
| 2023 Septiembre | 71 | 26 | 97 |
| 2023 Agosto | 40 | 18 | 58 |
| 2023 Julio | 36 | 36 | 72 |
| 2023 Junio | 50 | 18 | 68 |
| 2023 Mayo | 51 | 24 | 75 |
| 2023 Abril | 50 | 25 | 75 |
| 2023 Marzo | 34 | 19 | 53 |
| 2023 Febrero | 37 | 15 | 52 |
| 2023 Enero | 42 | 23 | 65 |
| 2022 Diciembre | 47 | 37 | 84 |
| 2022 Noviembre | 26 | 26 | 52 |
| 2022 Octubre | 24 | 13 | 37 |
| 2022 Septiembre | 24 | 34 | 58 |
| 2022 Agosto | 23 | 22 | 45 |
| 2022 Julio | 23 | 112 | 135 |
| 2022 Junio | 30 | 26 | 56 |
| 2022 Mayo | 39 | 27 | 66 |
| 2022 Abril | 56 | 42 | 98 |
| 2022 Marzo | 63 | 48 | 111 |
| 2022 Febrero | 38 | 23 | 61 |
| 2022 Enero | 48 | 27 | 75 |
| 2021 Diciembre | 34 | 33 | 67 |
| 2021 Noviembre | 38 | 42 | 80 |
| 2021 Octubre | 43 | 43 | 86 |
| 2021 Septiembre | 37 | 27 | 64 |
| 2021 Agosto | 35 | 26 | 61 |
| 2021 Julio | 26 | 26 | 52 |
| 2021 Junio | 43 | 28 | 71 |
| 2021 Mayo | 35 | 19 | 54 |
| 2021 Abril | 71 | 39 | 110 |
| 2021 Marzo | 71 | 22 | 93 |
| 2021 Febrero | 32 | 46 | 78 |
| 2021 Enero | 32 | 16 | 48 |
| 2020 Diciembre | 29 | 15 | 44 |
| 2020 Noviembre | 19 | 11 | 30 |
| 2020 Octubre | 12 | 7 | 19 |
| 2020 Septiembre | 23 | 4 | 27 |
| 2020 Agosto | 24 | 18 | 42 |
| 2020 Julio | 24 | 5 | 29 |
| 2020 Junio | 28 | 24 | 52 |
| 2020 Mayo | 24 | 15 | 39 |
| 2020 Abril | 43 | 17 | 60 |
| 2020 Marzo | 36 | 20 | 56 |
| 2020 Febrero | 2 | 2 | 4 |
| 2020 Enero | 4 | 4 | 8 |
| 2019 Diciembre | 8 | 2 | 10 |
| 2019 Noviembre | 6 | 0 | 6 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 4 | 1 | 5 |
| 2019 Agosto | 4 | 5 | 9 |
| 2019 Julio | 8 | 2 | 10 |
| 2019 Junio | 4 | 6 | 10 |
| 2019 Mayo | 7 | 8 | 15 |
| 2019 Abril | 2 | 7 | 9 |
| 2019 Marzo | 0 | 3 | 3 |
| 2019 Febrero | 4 | 48 | 52 |
| 2019 Enero | 2 | 0 | 2 |
| 2018 Diciembre | 2 | 1 | 3 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 7 | 1 | 8 |
| 2018 Agosto | 0 | 5 | 5 |
| 2018 Junio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 7 | 7 |
| 2018 Abril | 0 | 2 | 2 |
| 2018 Marzo | 0 | 2 | 2 |
| 2018 Febrero | 61 | 6 | 67 |
| 2018 Enero | 52 | 6 | 58 |
| 2017 Diciembre | 79 | 6 | 85 |
| 2017 Noviembre | 32 | 5 | 37 |
| 2017 Octubre | 32 | 3 | 35 |
| 2017 Septiembre | 39 | 6 | 45 |
| 2017 Agosto | 46 | 7 | 53 |
| 2017 Julio | 42 | 8 | 50 |
| 2017 Junio | 39 | 23 | 62 |
| 2017 Mayo | 36 | 13 | 49 |
| 2017 Abril | 47 | 13 | 60 |
| 2017 Marzo | 32 | 13 | 45 |
| 2017 Febrero | 28 | 9 | 37 |
| 2017 Enero | 99 | 9 | 108 |
| 2016 Diciembre | 30 | 17 | 47 |
| 2016 Noviembre | 44 | 14 | 58 |
| 2016 Octubre | 36 | 29 | 65 |
| 2016 Septiembre | 0 | 6 | 6 |
| 2016 Agosto | 0 | 2 | 2 |
| 2016 Julio | 10 | 3 | 13 |
| 2016 Junio | 21 | 1 | 22 |
| 2016 Mayo | 7 | 17 | 24 |
| 2016 Abril | 10 | 14 | 24 |
| 2016 Marzo | 4 | 1 | 5 |
| 2016 Febrero | 8 | 2 | 10 |
| 2016 Enero | 9 | 1 | 10 |
| 2015 Diciembre | 12 | 2 | 14 |
| 2015 Noviembre | 18 | 1 | 19 |
| 2015 Octubre | 8 | 3 | 11 |
| 2015 Septiembre | 8 | 6 | 14 |
| 2015 Agosto | 10 | 3 | 13 |
| 2015 Julio | 28 | 9 | 37 |
| 2015 Junio | 16 | 4 | 20 |
| 2015 Mayo | 18 | 14 | 32 |
| 2015 Abril | 15 | 14 | 29 |
| 2015 Marzo | 17 | 4 | 21 |
| 2015 Febrero | 6 | 2 | 8 |
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