May 07, 2019

What is the best way to look at skin cancer images?


5 min read

Skin cancer is the most commonly diagnosed cancer in the US. It occurs when skin cells are damaged, mostly as a result of overexposure or oversensitivity to UV rays. Melanoma of the skin, which is a specific type of skin cancer, is the 19th most common cancer worldwide. Remarkably, even though invasive melanoma accounts for just 1% of all skin cancer incidences, it is the major cause of death caused by skin cancer.1

Thanks to increased awareness as well as improved screening, the number of melanoma survivors is expected to increase by 22% in 20191. Self-examination and professional screening are vital to ensure better health outcomes. In both cases, images have a crucial role to play. But what is the best way to look at these? We’ll discuss in more detail here. But first, a bit of context:

Types of skin cancer

There are different forms of skin cancer: the melanoma skin cancers and the non-melanoma skin cancers. The latter include basal cell carcinomas (BCC) and squamous cell carcinomas (SCC).

Basal and squamous cell skin cancers are the most common forms of skin cancers. They mainly occur on parts of the body exposed to the sun. 


Skin cancer facts

The rise of skin cancer

Every year, 5 million people are diagnosed with skin cancer. Between 2008 and 2019, the number of new melanoma cases per year increased by 54%. In 2019, the number of new melanoma incidences is believed to increase by another 7.7%.1

Skin cancer prevention

Avoiding sun and UV exposure is the best way to reduce the risk of skin cancer. It means you need to cover most areas of skin and apply sun screen (SPF 15 is the bare minimum) every day.

Regular self-examination to check for early signs of skin cancer or signs of melanoma is recommended. Make sure to check every body part, even the soles of your feet! Think of Bob Marley who died of melanoma that started on his toe. In case of suspicious findings, always visit a dermatologist for closer inspection.

Skin self-exams

Surprisingly, 70 to 80% of melanomas appear on normal skin, and not in moles, as most of us would expect.1 When examining your own skin, you should be taking (mental) pictures of every body part so you can notice changes or evolutions in time.  It’s important to know your body and look for spots, sores and wounds that are healing slowly.

For more information about the symptoms of basal and squamous cell skin cancers, you can visit the website. It offers valuable information about what to look for on a self-exam of the skin. Symptoms may include rough red patches, wart-like growths and scarred tissue.

In the case of melanoma, the ABCDE rule has become best practice. It means you need to check for irregularities in the skin in terms of asymmetry (A), borders (B), color (C), diameter (D) and evolution (E). 

Professional skin exams

When screening for suspicious lesions, dermatologists will use a dermatoscope to look at the skin  in more detail. A dermatoscope can be analog or digital.

Analog dermoscopy

In the case of an analog dermatoscope, the dermatologist will look into a magnifying lens to closely observe the skin lesion. If the doctor wants to document the skin lesion, he or she will use a camera to take pictures. Afterwards, the images may be uploaded into a database for archiving and closer examination.

Digital skin images

When using a digital dermatoscope, dermatologists will look at skin lesions via a camera screen. They can also take pictures with the same device during the examination. This shortens the time needed to do the skin exam. Most dermatologists have about 15 minutes to spend on each patient. The more time they have to spend with patients instead of searching for different devices, the better.

Another benefit of digital skin imaging is that filing of these images can be done automatically. So again, patients get more ‘quality  time’ during their 15-minute consultation. Read this article if you want to find out more about the differences between analog and digital dermoscopy.

However, the greatest benefit of looking at digital skin images has to do with the detection probability of skin cancer. Digital dermoscopy makes it possible to photograph and follow up lesions over time. This means it becomes much easier to accurately track how lesions evolve2.

In addition, by using digital multispectral images, so-called skin parameter maps can be created. Skin parameter maps are currently a hot topic of state-of the-art research and the results look promising. Examples of these skin parameter maps are blood contrast and pigment contrast maps. They give an exceptionally clear view on skin structures, blood vessels and tissue composition.

As a result, digital skin images have the potential to improve the visibility of possible skin cancers and to make follow-up over time much easier and more accurate.

Research on digital skin parameter maps looks promising. These maps give an exceptionally clear view on skin structures, blood vessels and tissue composition.

How AI looks at skin cancer images

Artificial intelligence is a hot research topic in many medical disciplines. When a large amount of digital skin images are available, it becomes possible to develop a deep learning algorithm that can assist with detection and diagnosis of skin cancer.

AI could automate detection of dermoscopic details, for example.  And computer-aided ABCDE scoring can help doctors identify whether a skin lesion is benign or malignant.

What’s more, in the future, AI could provide medical advice to general practitioners when performing a first screening. The algorithm could provide risk scores and advise general practitioners to refer the patient to a dermatologist or do the follow-up themselves.  It means that dermatologists can give priority to high-risk patients.

This can help put an end to patient waiting times of three months or longer. When you know that health outcomes depend on early detection, this can potentially save lives.

Barco Demetra allows dermatologists to take any kind of picture and makes mapping, follow-up and comparison of skin images smoother and smarter.


About Barco Demetra

Barco Demetra™ is a revolutionary skin imaging platform co-developed with leading dermatologists. It combines the best of analog and digital skin imaging in a flexible, wireless handheld device. It allows dermatologists to take any kind of picture and makes mapping, follow-up and comparison of skin images smoother and smarter. Demetra is a platform that will evolve over time. We are continuously working on new groundbreaking capabilities, including deep learning algorithms, all developed to improve the quality of skin diagnoses.

Find out more at


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