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Teledermatology for suspected skin cancers

Total body and skin lesion examination

Created 2017.

Ensure good lighting. If necessary use an examination light, torch or ideally, large low-magnification dermatoscope.

  • Total body includes oral mucosa.  Genital examinations may be undertaken sensitively at times of prostate examination, cervical smear.
  • Scalp – use a comb or pencil to part hair  
  • Behind ears, under arms, in the groin, buttocks, between fingers and toes
  • Fingernails and toenails

Determine what’s normal for the individual:

  • Fitzpatrick Skin Phototype
  • Hair and eye colour
  • Degree of sun damage
    • Which body sites are affected?
    • Especially note actinic keratoses, solar lentigines
  • Pattern of melanocytic naevi
  • Pattern of seborrhoeic keratoses
  • Pattern of solar lentigines
  • Congenital lesions, especially melanocytic naevi
    • These should be stable (adult) or growing in proportion to the rest of the body (child)
  • Inflammatory skin conditions, ulcers, scars, infections etc.

Identify solitary lesions that are different from the other lesions:

  • These may be termed ugly duckling, black sheep etc
  • Lesions suspicious of melanoma
  • Lesions suspicious of keratinocytic skin cancer
  • Lesions in which there is diagnostic uncertainty

Record the lesion size/location and photograph it.

See smartphone apps to check your skin.
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