Question 1

How Expert Dermatologists Diagnose Melanoma

Accepted Answer

The following are interviews detailing how expert dermatologists approach their patients.

Their goals are to diagnosis skin cancer at the early stage while reducing the number of unnecessary skin biopsies.

Nearly all them share the same approach, and deploy similar cutting edge technologies.

Consider looking for dermatologists who share the similar philosophy and approaches.

Interview With the Experts

Dr. David Swanson

Dr. David Polsky discusses how he takes care of patients with high risk for melanomas.

Dr. Laura Ferris discussing how she takes care of patients with high risk for melanomas.

Dr. Justin Ko discusses his approach.

Dr. Trilokraj Tejasavi discusses his approach to manage skin cancer patients.

Dr. Harold Rabinovitz discusses various technologies he uses to follow his patients.

Dr. Allan Halpern discusses how we should screen melanoma for Asian, African Americans and Hispanic patient population

Question 2

The ABCDE Rule

Accepted Answer

The ABCDE rule is a good memory aid to help patients and physicians to detect melanoma.
A Stands for Asymmetry
B for border irregularity
C for multiple colors
D for diameter greater than 6mm
E for evolution or change

Interview with the Expert:
Dr. Darrell Rigel discusses how he and his colleagues at NYU first developed the ABCDE acronym over 30 years ago.

Question 3

Ugly Duckling Sign

Accepted Answer

The term “ugly duckling” refers to a lesion on the skin that does not share the same appearance as the moles in the nearby surrounding skin. This sign has been demonstrated to be a very effective way of identifying melanomas.
(Add a figure)
Watch the following experts discuss how they use ugly duckling sign to detect melanoma.

Question 4

Symptomatic Lesions

Accepted Answer

Pay attention to lesions with symptoms of pain, itching or bleeding.
Also pay attention to any lesions that have changed in shape, color, or size.
A lesion with symptoms or changes is not necessarily a malignant lesion. It simply means that you have to pay more attention to those lesions.

Question 5

Dermoscopy Exam

Accepted Answer

(self record a video about dermoscopy, show what it is. Show some benign and malignant images in a PPT manner)

Question 6

2D and 3D Total Body Photography

Accepted Answer

Total-body photography is another valuable tool that has clearly increased our ability to detect skin cancer at the early stage and to avoid unnecessary biopsies. It is mainly reserved for patients with numerous atypical nevi, (e.g., >40 to 50 moles)

These baseline photos help dermatologists and patients to monitor and track any lesions with changing features. New generation 3D total body photography system is more powerful, offering additional capability to help dermatologists to detect skin cancer at an earlier stage.

Interview With the Experts
Dr. Allan Halpern discusses the role of 2D and 3D total body photographic imaging.

Dr. Douglas Grossman discusses his approach using the mole mapping program

Question 7

Short-Term Follow Up with Digital Photos

Accepted Answer

There are lesions that are difficult to know if they are benign or malignant at the time of examination.
For certain patients and special anatomic locations, dermatologists may choose to image the lesion, and bring the patient back for a short term (i.e., 3 months) follow up.
It is important to never never deploy this strategy for any lesions that are nodular or raised. The reason is that, if the lesion happens to nodular melanoma, it can grow very fast in the short period.

Question 8

Confocal Laser Microscopy

Accepted Answer

A confocal laser microscope is an imaging device designed to examine skin tissue in a noninvasive fashion.
The resolution of the confocal image is exceedingly high. The clarity and magnification of confocal laser microscopy is comparable to that of standard microscopes.
It is very useful for detecting lentigo maligna on the face
Limitations include:
	o Time consuming process
	o Extensive training is required to capture and interpret the images to make the diagnosis.

Interview With the Experts:
Dr. Harold Rabinovitz (start from minute 2:10)

II. How Does a Dermatologist Find a New Melanoma?