Smartphone Application to Detect Skin Lesions
Condition: Skin Lesion
Study type: Observational

Summary: 
      The primary objective of Part One of this study is to determine the sensitivity of an
      automated total body digital photography (TBDP) app to detect color and size changes in the
      human skin, and whether a new lesion has arisen.

      The primary objective of Part Two is to test the sensitivity and specificity as well as
      feasibility of field use of an automated TBDP app to detect pigmented and non-pigmented skin
      lesions in high risk populations.
    

Detailed description: 
      SkinIO is an early-stage healthcare IT company specializing in education, early detection,
      and prevention of skin cancer. This study will utilize their product, skinIO, an enhanced
      full-body skin cancer screening system that works on mobile devices and tablets to track
      changes in skin over time without any additional imaging hardware. skinIO enables dermatology
      staff to photograph high-risk patients in 13 medical photography poses to quickly capture
      full-body skin surfaces at multiple resolutions using a mobile device. These images are
      automatically uploaded to a HIPAA-compliant server environment where they will be rapidly
      processed to detect any spots, lesions, and moles. Dermatologists will then be able to
      annotate these images and flag specific images for follow-up every month.

      In order to assess whether or not the software will accurately detect spot changes, the
      investigators will test the product on a sample of volunteer subjects.

      Part One:

      The study population will undergo one study visit. This visit will include 2 sets of photos
      taken by the research team after the collection of a small amount of identifying and contact
      information for each subject. There will be an initial 3-5 photographs taken of areas of the
      body that have at least 3 natural or artificial skin markings (ie. moles, angiomas, scars,
      keloids, seborrheic keratosis, small tattoos, etc). These markings will allow the app to
      calculate the parameters of any original lesions, and thereby more accurately detect new
      markings or changes based on these calculations. Once the original photographs are taken, one
      of each individual's original skin marking will be enhanced/enlarged with a marking pen, as
      well as 3- 5 new marks added to the skin. A Sharpie brush tip permanent marker will be
      utilized to make the new skin markings. These markers have been AP certified to be non-toxic.
      The following colors have been chosen: orange, black, brown, red, blue, purple, yellow and
      pink. A second photograph will be taken of the same areas of the body chosen for initial
      photographs to determine if the application could detect the changes. This group will not
      have their images sent to a dermatologist for evaluation, as they are artificially produced.

      Part Two:

      In order to test the sensitivity and feasibility of field of use of the TBDP app, a second
      convenience sample of patients will be recruited. Recruitment will be done in waiting rooms
      with the attending physician's consent. If needed, recruitment will be done outside of the
      waiting room in the form of flyers, website and e-mail announcements. This population will
      consist of patients with known high risk to have new/changing lesions, and who fall within
      the Fitzpatrick skin types I-IV. High risk patients include, but are not limited to, those
      with dysplastic nevus syndrome, previous history of melanoma/non-melanoma skin cancer, fair
      skin, >16 nevi, family history of melanoma, and/or immunosuppressed status. The first
      photography session will be taken by the research team in all 13 projections. Each projection
      corresponds to each body area that will be photographed to ensure total body photography.
      After the first visit, the patient will be instructed to take photographs every month for 12
      months using the TBDP app on their smart phone or tablet, and have follow-up research
      appointments every 6 months. The patient will be provided a user guide with written
      instructions for application use. The TBDP app has a built-in reminder system for the
      patient. Any changes detected by the app will be stored on the research team's database.
      Standard of care will be followed for any new/changing lesions. Patients will be recommended
      to have a follow-up appointment with their dermatologist, within 2 weeks. No procedures will
      be completed by the research team, and a physician will not be seeing the patients during
      their research appointments. During these visits, the research team will compare the
      photographs taken by the TBDP app to the patient's skin to see how sensitive the app is.
      Patients will continue their regular office visits at 6 months and/or 12 months as per
      standard of care for high risk patients. The research team will use information from chart
      reviews for assessment of the outcome for new or changing lesions.
    

Intervention name(s): Photos
Intervention type(s): Other
Intervention description(s): Photos will be taken of skin lesion markings using a smart phone or tablet
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Individuals with various skin types (Fitzpatrick I-IV)