New study verifies value of CSE  -  with or without dermoscopy

May 6, 2008

Graz, Austria - Though complete skin examination (CSE) by dermoscopy takes longer to conduct than CSE alone when screening for skin cancer, physicians should consider three-minute screening for the disease with either method, according to the results of a study reported by MedScape Today.

Graz, Austria - Though complete skin examination (CSE) by dermoscopy takes longer to conduct than CSE alone when screening for skin cancer, physicians should consider three-minute screening for the disease with either method, according to the results of a study reported by MedScape Today.

The study, published in the April issue of Archives of Dermatology, was conducted by researchers from Medical University in Graz, with a goal of measuring the time required to perform a CSE, with and without dermoscopy, as a means of screening for skin cancer.

The study covered a total of 1,359 patients with at least one melanocytic or nonmelanocytic skin lesion; they were randomized to receive a CSE without dermoscopy or a CSE with dermoscopy. The total number of lesions and duration of the CSE were determined for each patient.

For CSE without dermoscopy, the median time needed was 70 seconds, which increased to 142 seconds with dermoscopy. Although dermoscopy increased the duration of CSE and this increase was directly related to total count, the time required to perform a CSE without dermoscopy remained the same regardless of the number of lesions each patient had.

“The advantages of dermoscopy as an addition to the naked-eye skin-cancer screening are numerous but can be summarized as follows: improved diagnostic sensitivity for melanoma and nonmelanoma skin cancer and reduced biopsy rate of benign skin lesions,” the study’s authors write.

“Although the U.S. Preventive Services Task Force does not currently recommend routine CSE, claiming a lack of evidence for its efficacy in reducing mortality rates, recent studies reveal that a higher proportion of thinner melanomas are being detected during skin cancer screening than previously suggested.”

The authors note that the main limitation of their study was that each clinician randomized to conduct a CSE alone was permitted to perform a dermoscopic examination immediately on completion of the study, which might have resulted in an underestimation of the length of time required to perform CSE alone.

“A CSE aided by dermoscopy takes significantly longer than a CSE without dermoscopy,” the authors conclude. “However, a thorough CSE, with or without dermoscopy, requires less than 3 minutes, which is a reasonable amount of added time to potentially prevent the morbidity and mortality associated with skin cancer.”