A controversial new smart sticker can determine if a skin growth is melanoma without a surgical incision or scar, but some dermatologists tell SurvivorNet the sticker falls far short of a conventional biopsy.
The Pigmented Lesions Assay from DermTech works by using a smart sticker, which is placed over the mole in question. A quick circle is drawn around the mole in marker so the lab knows where to find the cells, and the sticker is then removed and placed onto a sheet with a special adhesive that protects the sample. The process takes less than 30 seconds and can test multiple moles all over the body in just a few minutes.Read More
These samples can be taken by a dermatologist or by an individual in the comfort of their own home during a telehealth visit. The technology is particularly appealing in the event of a pandemic as biopsies require the hand of medical professional.
There is also very little risk related to using the Pigmented Lesions Assay, with no serious adverse events reported among patients in a clinical trial.
The effectiveness of this technology has been touted in multiple studies. A 2017 study found that the test accurately determined that patients did not have cancerous melanoma cells in all but less than one percent of cases.
Another study, published just last year in JAAD found that the patch “reduces biopsies by 90 percent while improving care and reducing cost.” That study looked at 3418 concerning pigmented skin lesions from 53 dermatology offices across the country. The patient pool was 60.4 percent female and had a median age of 48 years old.
This technology has still failed to win over many dermatologists, however, with only seven practices in Manhattan actually using DermTech.
“I always feel better doing a biopsy because it’s such a minor procedure,” said Dr. Anna Karp of the Skin Institute of New York.
A second dermatologist who did not wish to be named because they had not tried the product echoed that sentiment, noting that in instances where the patient has melanoma the biopsy will be necessary regardless, so it is just adding an additional step along the way.
That is important to note. The sticker does not eliminate biopsies in instances where the test does detect cancerous cells. Those individuals will need to immediately contact their doctor or medical provider to schedule an appointment and get a closer examination of the growth.
The test is also not effective on certain areas of the body where the skin is ulcerated or bleeding, contains a scar, or was previously biopsied. Similarly, patients who suffer from psoriasis, eczema or similar skin conditions cannot use the test on areas where they may be experiencing breakouts. The test also can’t be administered on the palm of hands, soles of feet, nails, mucous membranes, or areas covered in hair unless it is shaved off or carefully trimmed to fully expose the site of the mole.
Finding melanoma at an early stage is key to successful treatment.
“As dermatologists, one of the most important things that we do every day is find early melanoma. We want to be able to find melanoma at its most curable stage where a simple excision is all that a patient needs, where we can find that lesion, remove it and not worry that it’s going to come back and cause problems for the patient,” said Dr. Laura Ferris, a dermatologist at University of Pittsburgh.
“One of the exciting developments that we’ve had in melanoma is that we can now actually understand a lot more about pigmented lesions. We know that there are certain genes that are expressed in evolving melanomas or in melanoma that we might not see in nevi (moles). We also know that melanoma progresses through the presence of DNA driver mutations.”
Dr. Ferris said a benefit of the non-invasive sticker system is that it requires no incisions and does not yield scars. “Being able to look at what’s going on inside the lesion, not just what we can see looking at it clinically or dermatoscopically, can give us insight into an individual lesion without having to remove it and give the patient a scar,” she told SurvivorNet.
Dr. John Dobak, president and CEO of DermTech, said that he came up with the idea for this new technology after an individual close to him was diagnosed with cancer.
“Someone in my life had a delayed melanoma diagnosis and ultimately succumbed to the disease — a disease that, as a medical doctor, I know is very treatable when caught early,” explained Dobak.
“I saw an opportunity to create a better approach to melanoma detection and potentially save lives.”
How To Check For Skin Cancer And Melanoma
Doing regular self-checks on your skin is important to find skin cancer early. If you’re high-risk, it’s especially vital. Dr. Cecilia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends looking at your skin once a month for anything suspicious–and using the acronym ABCDE as a checklist:
Asymmetrical moles: If you drew a line straight down the center of the mole, would the sides match?
Borders: Irregular, jagged, not smooth; can also stand for bleeding
Colors: Multiple distinct colors in the mole
Diameter: Larger than 6mm, about the size of a pencil head eraser
Evolution: This may be the most important, anything that is changing over time such as gaining color, losing color, painful, itching, hurting, changing shape.
Who Is A High Risk For Skin Cancer
There are a variety of different hereditary risk factors that can determine your risk of skin cancer, and some people are at a higher risk than others.
Some people are more at risk for melanoma than others. If you are fair-skinned, have blond hair and blue eyes, a family history of skin cancer and/or have many moles all over your body, you are at higher risk than most. If any of this applies to you, it’s even more important that you see your dermatologist regularly as well as do your own skin checks. It can help you determine your risk level so you can take measures to reduce your non-hereditary risk.