FotoFinder’s bodystudio Automated Total Body Mapping (ATBM) system — from FotoFinder Systems Inc — provides total body mapping and dermoscopy.
Skin cancer is the most common cancer in the United States and the number of new cases of melanoma has been increasing for at least 30 years. Melanoma is more likely to spread to nearby tissues and other parts of the body and can be harder to cure. Finding and treating melanoma early may help prevent death from melanoma.1 The ability to detect new moles and changes in existing moles is critical in the early detection process. The American Cancer Society recommends that part of a routine cancer-related checkup should include a skin exam by a healthcare professional qualified to diagnose skin cancer. Dermatoscopy is used to examine spots on the skin more clearly.2
How the ATBM System Works
The bodystudio ATBM is designed for maximum speed and efficiency and can take total body images (4 sides, palms and soles) in about 4 minutes. After the patient’s height is entered and the patient is positioned using FotoFinder’s advanced Guided Photography system, the camera starts taking photos, moving automatically up and down on the stand. Four photos per side are automatically captured and the system’s software automatically stitches the images of the patient together. The system also allows for up to 20 additional optional photos to be saved.
During follow-up visits, the ATBM’s Bodyscan module assists in identifying changed lesions and increases the process of evaluating and comparing lesions and moles. The module compares the baseline and follow-up images, attempts to match lesions and highlights new and visibly changed lesions, allowing physicians to determine which spots require dermoscopy. FotoFinder’ SmartZoom feature zooms in on both photos simultaneously and shows them at their full resolution for physician analysis. With the FotoFinder medicam, physicians can set markers on total body views to ensure moles are not missed and capture precise dermoscopy photos; the medicam provides magnification from 20x up to 70x. Dermoscopies are viewed by clicking on a marker in the total body image for side-by-side comparison with previous photos. Physicians can provide patients with photos for self-evaluation.
FotoFinder’s Laser Liner system delivers image consistency by projecting a red line on the floor for accurate patient positioning when taking baseline and follow-up images. For follow-up images, FotoFinder’s Ghosting feature displays a transparent baseline photo on top of the live video image, making it easy to align patients with their baseline images.
In a study of 618 patients at high risk for melanoma, Salerini et al3 found that digital follow-up with total body photography and dermatoscopy demonstrated early detection of melanomas with a low rate of excision. The Dermatologist Product Spotlight provides a summary of a study using the FotoFinder dermoscope in patients at high risk for cutaneous malignant melanoma (CMM).
1. Skin cancer prevention (PDQ). National Cancer Institute website. http://www.cancer.gov/cancertopics/pdq/prevention/skin/Patient/page2. Accessed February 24, 2015.
2. Melanoma skin caner. American Cancer Society website. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-detection. Accessed February 24, 2015.
3. Salerni G, Carrerra C, Lovatto L, et al. Benefits of total body photography and digital dermatoscopy (“two-step method for digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma. J Am Acad Dermatol. 2012;67(1):e17-e27.
Long-term Follow-up Study with Digital Dermoscopy
Bauer J, Blum A, Strohhäcker U, Garbe C. Surveillance of patients at high risk for cutaneous malignant melanoma using digital dermoscopy. Br J Dermatol. 2005;152(1):87-92.4
To evaluate the dermoscopic changes in the rates of excision in benign melanocytic naevi (MN) and CMM in long-term follow-up of high-risk patients using digital dermoscopy.4
Digital dermoscopic images of atypical MN in high-risk patients were analyzed retrospectively using the FotoFinder dermoscope. Images of all atypical MN of patients were taken at 20-fold magnification. The 20 to 30 most atypical MN were selected for follow-up in patients with a very high number of atypical MN. All images were evaluated by at least 2 individuals experienced in dermoscopy. Data collected for each atypical MN included changes in surface area, overall architecture, dermoscopic patterns and distribution of pigmentation. All tumors suspicious for melanoma or showing asymmetrical changes were excised and evaluated by histopathology.4
The study analyzed digital dermoscopic images of 2,015 atypical MN in 196 patients age 7 to 78 years attending the pigmented skin lesion clinic of the Department of Dermatology in Tübingmen, Germany. Patients were included in the follow-up because of atypical mole syndrome (AMS; N=168) or a history of CMM (N=68). AMS was defined as ≥5 atypical MN plus ≥50 common MN. Atypical MN had to meet at least 3 of the following 5 criteria: diameter ≥5 mm, ill-defined border, irregular border, varying colors within the lesion and papular and macular components. Follow-up was scheduled in intervals ranging from 6 to 12 months.
Patients with highly atypical MN without suspicion for CMM revisited after 3 to 6 months. All tumors suspicious for CMM at first visit were initially removed, resulting in excision of 12 pigmented tumors. Histopathology revealed 8 CMMs, 1 pigmented seborrhoeic keratosis and 3 dysplastic MN. These tumors were not included in the analysis as they were part of the follow-up.4
Results and Conclusion
During a median follow-up of 25 months, 77% of all patients had an estimated total body number of MN between 51 and 100. The number of MN followed up in each patient ranged from 1 to 34. The MN included in the study were localized mainly on the trunk of patients. Overall, 33 lesions were excised because they showed asymmetrical growth, newly developed eccentric hyperpigmentation or any dermoscopic structures associated with melanoma. In addition, 2 CMM in situ and 31 MN were diagnosed.
The results showed that from 2013 MN (excluding CMM) 128 (6.4%) of all naevi showed changes in size or architecture. Most changes were observed within the first 16 months of follow-up. In patients who attended more >1 follow-up visit, 88 MN changed, and 76 (86.4%) of these changes were already detected at first follow-up. Bivariate analysis of possible risk factors for growth and regression of MN showed a significantly higher risk for MN growth in younger patients (P<0.001), for MN localized on the trunk (P<0.001) and for patients with a positive history of CMM (P=0.040).
The researchers concluded that follow-up examination using digital dermoscopy revealed unchanged morphology in the large majority of MN. They suggested that advances in digital dermoscopy are particularly useful for naevus screening in patients at high risk for development of CMM. The ratio of 33 lesions excised in order to identify 2 CMM in situ seems reasonable. The authors noted this approach should be further evaluated in comparative, prospective studies.4
For more information on FotoFinder bodystudio ATBM, please visit www.fotofinder-systems.com or call 888-501-0805.