19/05/2025
A word to the wise, regarding automated total body mapping "automated full body mole scanners". If one includes simplified subclassification, there are at least 400 possible types and variants of skin cancer, other than melanoma. Carcinoma, specifically squamous cell carcinoma, has also surpassed melanoma in terms of number of deaths and fatality rate. The mucosa, which includes the inside of the mouth and ano-genital area, also falls under the responsibility of assessment by a dermatologist and adds another 50 or so possible cancer types to the list. The nail unit and hair-bearing skin, like the scalp, which is also part of the scope of responsibility for a dermatologist, adds another 20 or so to this list.
Medical and pediatric dermatology currently entails around 4,000-6,000 medical conditions, many of them possible subtle sentinels ("clues") to other underlying systemic conditions or even early cancers in other organs, which can save a patient's life by being picked up incidentally, during a normal examination where that was not the complaint and the patient was not even aware of it.
Full body automated mole mappers cannot, and have not been regulated or approved to pick up or diagnose any of the above, outside of melanoma, or replace any part of the clinical assessment required for them, which must be performed by the dermatologist him/herself. Having a so-called "re-assuring automated mole scanner report" in no way proves or implies that a patient is currently skin/mucosal/nail/scalp cancer-free or does not potentially have a significant undiagnosed disease.
The very reason the consensus guidelines still state that the entirety and basis of the assessment still starts and ends with TBSE (total body skin examination) is to inform that unless a total body skin examination has also been performed clinically, by the dermatologist, the patient has not been examined. In the same way, any physician e.g., cardiologist, will not replace the full assessment of a patient with a single scan/imaging modality. There is increasing evidence globally of rising rates of delayed, missed, and undiagnosed non-melanoma skin cancers and other important dermatological conditions in the setting of non-complete, rushed, or poorly performed clinical total body skin examination due to over-reliance on automated mappers. Mole mapping and the increasing assistance AI brings is important, positive, and significant. A mole-mapping should be done as PART of your global assessment, but, unless you have been physically examined, head to toe, by your dermatologist, in addition, you have not been assessed, and are in danger of the false reassurance risk paradigm.
