Imaging device looks underneath moles for melanoma

The MelaFind hand-held device at work.

Melanoma facts

Cause: Mostly by skin cells, damaged by ultraviolet radiation from the sun or tanning beds, mutating and forming tumors.

Cases: In 2009, the most recent year for which figures are available, 35,436 men and 26,210 women in the United States were diagnosed with melanoma. A total of 9,199 people – 5,992 of them men – died from it.

Know your melanoma ABCDEs: Asymmetry, uneven Borders, multiple Colors, Diameter larger than 6 millimeters and Evolution, meaning discernible changes in size, shape, color, elevation or any bleeding, itching or crusting.

Sources: Melanoma Research Foundation and the Skin Cancer Foundation.

Mole-hunting is a tricky science.

A gnarly-looking brown mound with a hair sticking out could be nothing more than a big ol' mole. On the flipside, a harmless-looking patch of pigmentation could turn out to be cancerous.

A relatively new device used by a handful of California dermatologists is offering a closer look.

MelaFind is a digital imaging device that takes a picture revealing what's going on just under the skin. When aimed at worrisome-looking moles and other spots, it can give doctors a heads-up on which areas might need to be analyzed further. MelaFind was approved by the FDA in 2011 and is slowly making its way into exam rooms across the country.

Two providers use it in Orange County, according to the company's website: Laguna Woods Dermatology and Dr. Samireh Z. Said in Tustin.

MelaFind alone won't replace the other tools used in the fight against melanoma, the deadliest of skin cancers. A trained dermatologist has to determine which set of moles to scrutinize; typically a "card" in the MelaFind computer can hold up to eight high-resolution pictures per patient (newer systems can store hundreds of images on a card). And a traditional biopsy, when a small chunk of the skin, removed by a needle, is sent for analysis, still likely will be necessary to tell whether it's cancer.

But the device, developed by MELA Sciences of Irvington, N.Y., is another tool that could lead to early detection of melanoma, a disease that's expected to cause more than 9,000 deaths in the United States this year, according to the American Cancer Society.

"As scary as it is, people are still living in that world of, 'I'll never get it,'" said Dr. Glynis Ablon, an associate professor at UCLA's David Geffen School of Medicine and founder of the Ablon Skin Institute in Manhattan Beach.

Her practice was the first on the West Coast to start using MelaFind. Although she recommends that adults get a full-body exam once a year ("Check your birthday suit on your birthday," the saying goes in the industry), the gadget has helped her catch cancerous lesions that otherwise might have been missed using just the naked eye.

The system only identifies patches that might be melanoma, not other types of skin cancer. The most common kind, basal cell carcinoma, looks like a pimple that doesn't heal, but it rarely spreads to other parts of the body; it's very treatable. Squamous cell carcinoma also appears as a non-healing lesion, often with a thickened crust on the top; it can spread to the lymph nodes, and can turn deadly if left untreated.

Here's how the MelaFind process works:

• After spraying alcohol on the skin area to be targeted, and shaving off any nettlesome hairs, the device, which looks like a radar gun used to measure pitches at a baseball game, is placed directly on the area.

• MelaFind, using 10 wavelengths of concentrated light (no UV rays or X-rays), penetrates 2.5 millimeters into the skin. Under dermatologists' guidelines, any mole 6 mm in diameter or larger is enough to raise suspicion, but MelaFind can analyze much smaller moles.

• The computer compares the image to thousands of pictures of moles (both melanomas and noncancerous moles) in its database, and spits out a number on a scale. Anything below 0.0 indicates low "disorganization," meaning a decreased level of irregular growth pattern of the mole. "If it comes back low, we watch it, and we've saved a needle stick," Ablon says. "If it comes back high, that's when I get worried."

A reporter tried the system, and an area of skin that looked otherwise normal actually looked quite irregular when enlarged on the monitor. The number on the monitor said 2.652, triggering a message saying "high disorganization." It's high enough to warrant a biopsy.

"I don't think it's melanoma," Ablon said. But the biopsy will tell for sure.

MELA Sciences says that in clinical trials, the device detected melanoma 98 percent of the time. But it's not foolproof. Some moles are camera-shy, and the hand-held instrument has trouble getting a good picture of them. The company says that 9 percent of moles are "non-evaluable," meaning the data on them can't be analyzed.

Another issue is cost as insurance generally doesn't cover an exam. Ablon's office charges $150 for a session that includes analyzing up to eight images. One of the O.C. offices quoted the same price. Of course, if a biopsy is needed, insurance likely would cover a portion of that, depending on the plan.

Whether or not you seek out this screening tool, this is Southern California, after all. So keep an eye on those moles and other pigmented patches.

"Don't use elevation as a guide," Ablon advised. "Melanomas can be raised or flat."

They also can get bigger, their color can change, and their borders can move around, which can indicate normal or not normal.

Do self-examinations. Areas of the skin that have a long history of overexposure should be watched, but if there's a hereditary inclination toward melanoma, lesions can show up in other places on the body that are not exposed, including the legs and groin.

Contact the writer: or 714-796-2221

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