Total body photography as an aid to diagnosing malignant melanoma

Linked Article:   Ji‐Xu A et al. Br J Dermatol 2021; 185 :302–312. Melanoma accounts for 5% of skin cancer cases but up to 75% of skin cancer deaths. Early detection of melanoma can reduce morbidity and mortality. Total body photography (TBP) is increasingly used in patients at high risk of melanoma to help identify both suspicious new lesions and changes in pre‐existing lesions. This systematic review from the UK reviewed the literature to determine the diagnostic accuracy of TBP in diagnosing melanoma in patients at high risk. Ten studies were included, comprising over 41 000 patients who underwent TBP and 6203 biopsies (where a small section of tissue was removed for testing). After TBP assessment, the average percentage of biopsies positive for early stage or invasive melanoma was 15%. On average, 8·6 lesions needed to be biopsied to detect a melanoma. This number was considered acceptable and lower than previous studies using clinical examination alone. The studies included showed considerable variability in the way in which at‐risk patients were chosen and in the TBP protocols used. Therefore, further prospective, comparative studies are required to make a more accurate assessment of the effectiveness of TBP compared with standard care alone.