Real-world outcomes of melanoma surveillance using the MoleMap NZ telemedicine platform - 30/03/20

Doi : 10.1016/j.jaad.2020.02.057

Elizabeth Greenwald ^a, Andrea Tan ^a, Jennifer A. Stein, MD, PhD ^a, Tracey N. Liebman, MD ^a, Adrian Bowling ^b, David Polsky, MD, PhD ^a,^⁎
^a The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
^b MoleMap New Zealand Ltd, Auckland, New Zealand

^∗Reprint requests: David Polsky, MD, PhD, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 530 1st Ave, Ste 7R, New York, NY 10016.The Ronald O. Perelman Department of DermatologyNew York University School of Medicine530 1st AveSte 7RNew YorkNY10016

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Abstract

Background

MoleMap NZ is a novel New Zealand–based store-and-forward telemedicine service to detect melanoma. It uses expert review of total body photography and close-up and dermoscopic images of skin lesions that are suspicious for malignancy.

Objective

The purpose of this study was to assess the effectiveness of MoleMap NZ as a melanoma early detection program.

Methods

We conducted a review of 2108 melanocytic lesions recommended for biopsy/excision by MoleMap NZ dermoscopists between January 2015 and December 2016.

Results

Pathologic diagnoses were available for 1571 lesions. Of these, 1303 (83%) lesions were benign and 260 (17%) lesions were diagnosed as melanoma, for a melanoma-specific benign:malignant ratio of 5.0:1. The number needed to biopsy to obtain 1 melanoma was 6. Among melanomas with available tumor thickness data (n = 137), 92% were <0.8 mm (range in situ to 3.1 mm), with in situ melanomas comprising 74%.

Limitations

Only lesions recommended for excision were analyzed. Pathology results were available for 75% of these cases. Tumor thickness data were available for 53% of melanomas diagnosed.

Conclusions

This real-world study of MoleMap NZ, a community-based teledermoscopy program, suggests that it has the potential to increase patients' access to specialist expertise via telemedicine. Additional studies are needed to more accurately define its efficacy.

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Key words : dermoscopy, melanoma, sequential digital dermoscopy, store-and-forward telemedicine, teledermoscopy, total body photography

Plan

Methods

Overview of the MoleMap NZ melanoma screening procedure

Study methodology

Results

Patient characteristics

Characteristics of lesions recommended for removal

Melanoma characteristics

Discussion

Limitations

	Ms Greenwald and Ms Tan contributed equally to this article.
	Funding sources: None.
	Disclosure: Mr Bowling is founder and Chief Technology Officer of MoleMap NZ Ltd. The NYU Department of Dermatology has a contract with MoleSafe USA, the United States licensee of MoleMap NZ, to provide diagnostic services. Drs Stein, Liebman, and Polsky diagnose patients for MoleSafe USA (but not MoleMap NZ), for which they receive payments from the NYU Department of Dermatology. Ms Greenwald and Ms Tan have no conflicts of interest to disclose.