DURHAM, NC--A researcher at Duke Comprehensive Cancer Center has
pioneered the use of CD-ROM technology to preserve a photographic
record of the skin and to detect the earliest signs of melanoma.
While "total body photography" has become a common tool
to help physicians screen patients at high risk for melanoma,
James Grichnik, MD, believes that he is the first to take the
additional step of preserving photographs of his patients' skin
on CDs for computers.
Dr. Grichnik, assistant professor of medicine, combines conventional
photography with CD technology to create a digital baseline. He
also uses epilumines-cence, a procedure carried out with a hand-held
microscope, to look even more closely at any moles that appear
to have changed. A new computer database allows him to track his
Patients who come to the pigmented lesion clinic directed by Dr.
Grichnik and who are found to be at high risk for melanoma are
photographed from 33 different angles, covering as much of the
skin surface as possible. Instead of being stored as slides or
prints, the images are transferred to CD-ROMS (see photograph).
The disks are economical to create, easy to store, and convenient
to use, Dr. Grichnik said.
Each patient has his or her own disk. When the patient comes in
for a visit, Dr. Grichnik pops the disk into his computer and
makes a direct comparison between moles on the patient's skin
and the images on the computer screen, where he can easily zoom
in on specific moles.
For now, the CD-ROM record remains at Duke, he said. However,
it may one day become a part of the patient's electronic medical
The real key to early detection, Dr. Grichnik said, is for patients
to recognize their risk and to get regular, high-quality screenings.
"CD-ROMs and epilumines-cence just give us new tools to determine
moles that are changing."