All you need to know about Mole mapping
What is mole mapping?
Mole mapping is a surveillance programme used for people who have a high risk of malignant melanoma. It involves a clinical skin examination and dermoscopy to identify moles or lesions that are of some concern.
Mole mapping also involves marking skin lesions of concern on the body, especially freckles and moles. Mole mapping refers to conventional print photographs or digital images of the entire bodies’ skin surface. These images are viewed at a later date to see if new skin lesions have appeared or if the pre-existing lesions have grown, changed colour or shape.
These machine detections are very accurate in seeing if lesions have changed, but they should not substitute a clinical evaluation by a doctor.
Digital mole mapping
Digital mole mapping might include:
- Risk evaluation: your age, family as well as medical history, skin type and sun exposure
- Educating the patient of sun protection, moles and melanoma
- A doctor or a trained nurse will do a skin examination
- Photos of high quality (digital) will be taken
- Standard poses of the whole body, with the lesions of concern carefully localised
- Close-up macro images of the lesions of concern
- Dermoscopic images of lesions of concern
- A dermatologist who is a skin cancer expert will evaluate the images
- A full report including suspected diagnoses, recommendations and treatment will be sent to the patient and/or to the referring doctor
- For the lesions that did not reach the threshold for excision, the patient will have follow up mole mapping in 3-6 months
- A follow up mole mapping of all imaged lesions will be done in 1-2 years
- There is a secure database and a transfer system that stores all the images and all the reports
- The patient or the doctor will receive copies of the images for aiding in self skin examination
All outer clothing has to be removed, and if there are lesions under the underwear they will have to be removed as well. Any make-up, cutex as well as jewellery must be removed prior to the procedure. If you have long hair it should be tied up.
Who is suitable for mole mapping?
Mole mapping is for people who have:
- Many moles (between 50 and 100)
- Large moles that have unusual colours and or shapes (dysplastic or atypical naevi)
- If you have moles on your back
- If you have had a previous history of melanoma
- If you have a family history of melanoma
- Moles, and fair skin that has been sunburned
- If your moles or freckles have changed recently
Mole mapping is extremely useful for pigmented moles which are a light to dark brown.
What are the advantages of mole mapping?
- By looking at the previous records, it can be determined if a new lesion has appeared or if an existing one has changed
- If a lesion has the criteria for removal, it can be done at the earliest possible stage which will reduce the risk of melanoma as well as minimising surgery
- If the legions have not reached the threshold for removal, they can then be closely monitored for any changes
- It identifies which lesions are not melanoma, therefore reducing the potential risks, costs and complications of surgery
- Earlier expert evaluation, so you do not have to wait for months before you can see a dermatologist
- Reassurance to the patient and their health practitioner
What are the risks of mole mapping?
As with any other medical procedures mole mapping also has its own risks:
- Detecting melanoma in hidden places such as the scalp or genital area that have not been imaged
- If the melanoma is in its very early stages the results could show up false negative
- A harmless lesion could show up as melanoma, resulting in unnecessary surgery and alarm –false positive
- Melanoma could grow rapidly and reach a dangerous size before your next mole mapping visit
- Non-pigmented skin lesions are sometimes imaged during a mole mapping visit. They include skin cancers: amelanotic melanoma, basal cell carcinoma and squamous cell carcinoma. Sometimes pink or scaly skin cancers may be difficult to distinguish from harmless lesions, as the photographic appearance may be identical
- This procedure could be embarrassing and / or expensive