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Wednesday 21st August 2019

Warning over skin check smartphone app

22nd January 2013

Researchers in the United States have warned people not to rely on smartphone applications designed to analyse skin lesions for possible skin cancer.


A research team led by Laura Ferris, of the University of Pittsburgh Medical Center in Pennsylvania found in a recent study that the apps are not always very good at telling the difference between cancerous and non-cancerous lesions.

Writing in the journal JAMA Dermatology, Ferris and her colleagues said that even though the apps have not been approved by the Food and Drug Administration as a medical device, some people may rely on them for diagnosis.

The apps use algorithms to analyze skin lesions, not always accurately, and experts say that people may take longer to seek a diagnosis for lesions that can be life-threatening because of of them.

According to dermatologist Karen Edison of the University of Missouri in Columbia, a smartphone app is no substitute for an examination by a skin specialist.

Edison said the app could be useful to reassure someone whose skin lesion was benign, but there were other problems with the practice.

Even patients whose melanoma is correctly diagnosed may not know where to go for a biopsy or have the means to pay for it.

Ultimately, technology is still only a tool, she said.

Four smartphone apps were given 188 photographs of lesions which had already received an expert diagnosis.

Of those, 60 were melanoma and the remainder were benign.

Three of the apps, all of which cost £2-3 (up to $5) to buy, function using algorithms to analyse photographs for possibly cancerous lesions.

The fourth app sends images submitted by users to a certified dermatologist for evaluation.

The most accurate of the algorithm-based apps failed to spot melanoma in 18 out of 60 cases, Ferris and her colleagues found.

She said the risk of a melanoma going unrecognised because a smartphone user trusted the app was "pretty big."

The longer melanoma is left without diagnosis or treatment, the more entrenched it becomes, and the harder to treat.

It is also more likely to spread around the body and pose a threat to a person's life, Ferris and her team said.

The app that sent the photos to a human expert only missed one melanoma diagnosis out of 53, however.

Most of the apps found cause for alarm in more than half of the cases where cancer had already been ruled out, suggesting a high rate of false positives was likely.

Websites that advertise similar apps warn people never to allow them to replace expert medical advice.

They say the intention behind their apps is to help people keep better track of their moles from day to day.

Ferris said that apps that remind people to carry out their own skin check were probably better value, however.

According to Edison, people who live in remote areas without access to specialist care can benefit from teledermatology, however.

She said she had once diagnosed a farmer's melanoma remotely using video and photographs.

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