Keeping track of potentially dangerous skin lesions and moles, and charting any changes in them, is now much easier with Cayman Doctors’ FotoFinder mole mapping system. 

In the past, skin cancer checks involved a paper chart whereby the examining physician would mark the approximate location and size of moles on a schematic drawing of the body. With the German-engineered FotoFinder mole mapping system, a series of digital photographs are taken of the front, back and sides of the patient, as well as the soles of the feet (and other areas such as scalp, etc.) when indicated, says Dr. Else Christoffersen of Cayman Doctors. The whole body photography takes about seven minutes. The physician can then tag each lesion that they wish to keep track of on the photographs and the data is stored electronically. 

When a person has hundreds of moles, explains 

Christoffersen, it is nearly impossible to identify one particular mole, from a drawing with many marked on it. The FotoFinder system removes this problem as each mole is tagged with an identifying number. 

When a patient returns for his or her annual examination, the new photographs are overlaid on the initial or baseline images, for a much more accurate comparison. If there are any new moles the software will automatically identify these as well as changes to previously documented moles. 

“Anything that is larger than 0.5 centimetres (or ¼ inch) in diameter is worth keeping an eye on,” says Christoffersen. “We look out for any changes in colour i.e darkening, loss of colour and new colouration, increase and decrease in size and thickness, changes in the surrounding skin (i.e redness, white spots and swelling), as these are all warning signs that a previously harmless mole could be developing into a malignant melanoma. Other danger signals include itchiness, sores, odd sensations and bleeding moles. New moles which appear after age 25 years should also be checked out.”  

Suspicious looking moles that require closer examination are photographed with a dermoscope (a specialised camera), which is placed directly on the lesion. The software links the close up view numerically to the overview photograph and analyses the lesion, picking out the border, colour, asymmetry and size and rating it in terms of how harmful it might be. All this data is of course stored in the system.  

Christoffersen stresses that the computer analysis is treated as a second opinion but does not replace the physician’s examination. She will still examine the patient’s skin minutely, including going over the skin with an ultra violet light which identifies the sun damage and to screen for non-melanoma skin cancers.  

The patients is given a CD of his or her whole body photographs so that they too can look out for changes at home, make comparisons, and have the data available to show other physicians should they go elsewhere for their next mole check. 

Basal cell carcinomas and squamous cell carcinomas are by far the most common types of skin cancer and are a direct consequence of UV exposure and sun damage, says Christoffersen. These most commonly appear on the face, neck, chest area and on the scalp of those with little or no hair - the areas that tend to be most exposed to the sun. The good news, however, is that both are slow growing and unlikely to spread.  

Malignant melanoma is the most dangerous type of cancer, which grows fast and metastasises early so needs to be diagnosed and treated without delay. In recent years, the number of melanoma cases has increased significantly. One out of 100 diagnosed skin cancers is a malignant melanoma. It can arise from moles or healthy skin. This type of skin cancer can occur anywhere on the body, including under finger and toe nails and, very rarely, in the eye. Changes in vision and bluish patches or streaks under the nails are warning signs to be taken seriously.  

Although melanoma is 100 per cent curable if diagnosed early, says Christoffersen, it if it’s not detected soon enough, it can be fatal.  

Individuals with fair skin, red hair and freckles are most at risk of sun damage and skin cancer. However, it can occur in people of any ethnicity. The problem, says Christoffersen, is that it can be much harder to detect lesions in darker skinned people, which means that by the time it is diagnosed it is often more advanced. 

Skin checks should be carried out annually and for some patients more frequently. This is especially important if there is a personal or family history of skin cancers, if you have multiple moles (more than 50), if you have large congenital moles (diameter larger than 1.5 cm or ½ inch), if you have conspicuous or recently changed moles or if you suffered severe sunburn during childhood and adolescence or have any condition that would make the you more prone to skin cancer (such as xeroderma pigmentosum or have a depressed immune system). In the latter cases skin check must be more frequent as the risk of cancer is greatly increased. The cost of skin check is often covered by health insurance.