Project Grant R41EB032304

SYSTEM FOR DOCUMENTING AND TRACKING SKIN LESIONS - PROJECT SUMMARY THE OBJECTIVE OF THIS STTR PROPOSAL IS TO DEVELOP A SYSTEM FOR LONGITUDINALLY TRACKING THE LOCATIONS AND MORPHOLOGIC CHANGES TO ALL PIGMENTED SKIN LESIONS ON THE PATIENT'S BODY. THE PROPOSED SOFTWARE WILL BUILD ON A PREVIOUSLY DEVELOPED TOTAL BODY PHOTOGRAPHY (TBP) SYSTEM, CALLED LUMO SCANNER, THAT CAN PROVIDE UNPRECEDENTED RESOLUTION ACROSS THE ENTIRE BODY SURFACE. SKIN CANCERS, INCLUDING BOTH MELANOMA AND NON- MELANOMA, ARE THE MOST COMMON TYPE OF CANCER IN THE UNITED STATES. EARLY-STAGE IDENTIFICATION OF SUSPICIOUS PIGMENTED LESIONS (SPLS) IN PRIMARY CARE SETTINGS CAN LEAD TO IMPROVED MELANOMA PROGNOSIS AND A POSSIBLE 20- FOLD REDUCTION IN TREATMENT COST. THE PROPOSED DEVICE SIGNIFICANTLY REDUCES THE CLINICIANS' TIME REQUIRED FOR DOCUMENTING LESIONS AND FOR MAKING DIAGNOSTIC DECISIONS, THEREBY ALLOWING THE HEALTHCARE SYSTEM TO BETTER COPE WITH THE FORECASTED SHORTAGES OF DERMATOLOGISTS. THE PROPOSED TECHNOLOGY IS NOVEL IN THAT IT: 1) PROVIDES A STANDARDIZED WAY OF REFERRING TO LESIONS' LOCATIONS, 2) ALLOWS DERMATOLOGISTS TO MAINTAIN A COMPLETE HISTORICAL RECORD OF EVERY LESION 3) DETECT SIGNIFICANTLY CHANGED (EVOLVED) LESIONS AND 4) ASSISTS DERMATOLOGISTS IN FINDING CANCEROUS LESIONS AT THEIR VERY EARLY STAGES TO IMPROVE OVERALL PATIENT PROGNOSIS. THE PROJECT TEAM HAS ALREADY DEVELOPED A TOTAL BODY PHOTOGRAPHY (TBP) SYSTEM THAT IS UNLIKE THE COMMERCIALLY AVAILABLE SYSTEMS IN THAT IT OBVIATES THE NEED FOR USING A DERMATOSCOPE AND CAN PRODUCE IMAGES OF SUFFICIENT RESOLUTION THAT CAN BE USED FOR EARLY DETECTION OF SKIN CANCERS. THIS DEVICE HAS ALREADY RECEIVED AN IRB AND HAS BEEN INSTALLED AT JOHNS HOPKINS (JHU) OUTPATIENT CENTER FOR ITS FIRST CLINICAL STUDY. BY YOUR READING OF THIS PROPOSAL IS UNDER REVIEW, JHU'S 100-PATIENT STUDY IN WHICH THE EFFICACY OF SCAN-BASED EXAMINATIONS WILL BE COMPARED WITH THE EFFICACY OF TRADITIONAL CLINICAL AND DERMATOSCOPIC-BASED SKIN EXAMINATIONS, IS WELL ON ITS WAY. WITHIN THIS PROPOSAL TEAM INTENDS TO DEVELOP A TEMPORAL STUDY TOOL THAT CAN FOLLOW ALL PSLS OVER TIME REGARDLESS OF PARTICIPANTS' POSE AND WEIGHT CHANGES BETWEEN SCANNING SESSIONS. SUCH A SYSTEM WILL ENABLE CLINICIANS TO ACCURATELY MONITOR PATIENTS' PSLS OVER TIME, DOCUMENT ANY CHANGES IN PREVIOUSLY IDENTIFIED LESIONS, AND DETECT NEW LESIONS AT THE POINT OF CARE. WITHIN, THE TWO PHASES OF THIS PROJECT, THE TEAM WILL ALSO FOCUS ON DETECTING EVOLVED LESIONS AND OPTIMIZING THE SCANNING SOFTWARE TO PROVIDE A BETTER USER INTERFACE FOR FOLLOWING AND DIAGNOSING PIGMENTED SKIN LESIONS (PSL) WHILE REDUCING THE AMOUNT OF TIME IT TAKES FOR THE DERMATOLOGIST TO FULLY DOCUMENT THE PATIENTS LESIONS OF INTEREST. THOUGH SOME LITERATURE SUGGESTS THE EPIDEMY IN MELANOMA IS THE RESULT OF OVER-SCREENING AS EVIDENCED BY THE NUMBER OF DEATHS NOT INCREASING COMMENSURATELY, OTHERS SUGGEST THAT THE LOW DEATH-RATE IS THE RESULT OF BETTER SCREENING. REGARDLESS, THERE IS UNANIMOUS AGREEMENT THAT TOO MANY LESIONS ARE STUDIED BY PATHOLOGISTS. LUMO SCANNER WHEN COMBINED WITH THE FACILITIES DEVELOPED IN THIS PROJECT, WILL ENABLE TECHNICIANS PERFORM HIGHLY ACCURATE SCANS AND THUS ALLOW THE DERMATOLOGIST TO SPEND LESS DOCUMENTING THE HIGH-RISK PATIENTS. ALSO, THIS NOVEL DEVICE WILL ENABLE TELEDERMATOLOGY IN AREAS WHERE THERE IS A SCARCITY OF DERMATOLOGISTS. ADDITIONALLY, THE PROPOSED DEVICE CAN ALSO BE USED FOR DIAGNOSING AND ACCURATELY MONITORING THE EFFICACY OF THERAPIES FOR PSORIASIS, ATOPIC DERMATITIS, AND OTHER INFLAMMATORY SKIN CONDITIONS. PSORIASIS AND ATOPIC DERMATITIS ARE ALSO SERIOUS GLOBAL PROBLEMS. IN THE UNITED STATES, PSORIASIS AFFECTS ABOUT 8 MILLION PEOPLE WHILE ABOUT 31.6 MILLION PEOPLE IN THE UNITED STATES HAVE SOME FORM OF ECZEMA, INCLUDING ATOPIC DERMATITIS.