The use of mole-mapping diagrams to increase skin self-examination accuracy

Background: Monthly skin self-examination (SSE) is associated with reduced incidence of advanced melanoma, but SSE is prone to error in detecting early changes of melanoma. Objective: We sought to improve SSE accuracy by requiring participants to complete a mole-mapping diagram. Methods: After completing a baseline survey, participants received SSE instruction, had their backs digitally photographed, and half were randomized to complete a mole-mapping diagram. Some photographs were altered by adding an image of a 5-mm pigmented lesion. At follow-up, participants were asked to identify any changes introduced to their photographs. Results: A total of 88 participants completed the study. in all, 33% (n = 15) of the control group (no diagram) and 52% (n = 22) of the intervention group (mole-mapping diagram) (P =.06) gave accurate assessments. Analysis of only altered images indicated that the intervention group gave more accurate assessments (60% vs 33%, P =.01). Limitations: This study was limited by sample size, only addressed lesions on the back, and did not involve actual melanomas in study participants. Conclusions. Mole-mapping diagrams may improve SSE accuracy, and may be useful as a simple, cost-effective intervention in reducing melanoma mortality.