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.
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 record.
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."
