The Principles of Examination of Patients with Detected Melanoma Suspected Skin Neoplasm in the Primary Health Care Stage

Currently, in the structure of mortality in the Russian Federation and a number of other countries, oncological diseases occupy a leading position among other causes. Melanoma of the skin is one of the most aggressive malignant tumors, with rapid progression, often leading to death in a fairly short time. Early detection and rationally organized refferral of patients with diagnosed skin melanoma in primary health care settings is aimed at reducing morbidity and mortality from malignant diseases, and improving the quality of life of patients. Research results suggest that the increased incidence of skin melanoma is due to both overdiagnosis. and an increase in the alertness of doctors and the population in relation to pigmented skin formations. The article discusses the proven risk factors for the development of skin melanoma, since this disease is potentially reversible. Attention is paid to modern clinical methods for predicting the course of skin melanoma. The review article examines computer-based methods for screening and diagnosing skin melanoma, applicable in primary health care settings. A separate section is devoted to dermatoscopy or epiluminescence microscopy, which refers to the study of pigmented skin lesions using surface microscopy. A list of studies is presented in case of suspicion of a malignant neoplasm of the skin / melanoma of the skin in a patient who sought medical help at a medical and prophylactic institution. The significance of the criteria of the ABCDE algorithm, the “Argenziano” algorithm in the study of pigmented skin lesions with further analysis of the results by artificial intelligence for decision-making is discussed.

1. Erdmann F, Lortet-Tieulent J, Schüz J, et al. International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk? Int J Cancer. 2013; 132: 385–400. doi: 10.1002/ijc.27616

2. Arnold M, Holterhues C, Hollestein L.M., et al. Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015. J Eur Acad Dermatol Venereol. 2014; 28: 1170–8. doi: 10.1111/jdv.12236

3. Kaprin A.D., Starinskij V.V., Petrova G.V. Malignant neoplasms in Russia in 2018 (morbidity and mortality). M.: MNIOI P.A. Herzen branch of the National Medical Research Center of Radiology. 2019; 252 p. [in Russian].

4. Kaprin A.D., Starinskij V.V., Petrova G.V. Malignant neoplasms in Russia in 2019 (morbidity and mortality). M.: MNIOI P.A. Herzen branch of the National Medical Research Center of Radiology. 2020; 252 p. [in Russian].

5. Kaprin A.D., Starinskij V.V., Petrova G.V. Malignant neoplasms in Russia in 2017 (morbidity and mortality) — Moscow: MNIOI im. P.A. Herzen is a branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” of the Ministry of Health of Russia. 2018; 236 p. [in Russian].

6. Coory M., Baade P., Aitken J. et al. Trends for in situ and invasive melanoma in Queensland, Australia, 1982–2002. Cancer Causes Control. 2006; 17: 21–7. doi: 10.1007/s10552-005-3637-4

7. Jemal A., Saraiya M, Patel P. et al. Recent trends in cutaneous melanoma incidence and death rates in the United States, 1992– 2006. J Am Acad Dermatol. 2011; 65(Suppl 1): S17–25.e11–13. doi: 10.1016/j.jaad.2011.04.032

8. de Vries E., Bray F.I., Coebergh J.W. et al. Changing epidemiology of malignant cutaneous melanoma in Europe 1953–1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia. Int J Cancer. 2003; 107: 119–26. doi: 10.1002/ijc.11360

9. Thomas L., Tranchand P., Berard F. et al. Semiological value of ABCDE criteria in the diagnosis of cutaneous pigmented tumors. Dermatology (Basel). 1998; 197: 11–17. doi: 10.1159/000017969

10. Cornish D., Holterhues C., van de Poll-Franse L.V. et al. A systematic review of health-related quality of life in cutaneous melanoma. Annals Oncol. 2009; 20(Suppl 6):vi51–8. doi: 10.1093/annonc/mdp255

11. Guy G.P., Machlin S.R., Ekwueme D.U. et al. Prevalence and costs of skin cancer treatment in the U.S., 2002–2006 and 2007–2011. Am J Prev Med. 2015; 48: 183–7. doi: 10.1016/j.amepre.2014.08.036

12. Gandini S, Sera F., Cattaruzza M.S. et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005; 41: 45–60. doi: 10.1016/j.ejca.2004.10.016

13. Gandini S., Sera F., Cattaruzza M.S., et al. Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005; 41: 28–44. doi: 10.1016/j.ejca.2004.10.015.

14. Gandini S., Sera F., Cattaruzza M.S. et al. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005; 41: 2040–59. doi: 10.1016/j.ejca.2005.03.034.

15. Koelink C.J.L., Kollen B.J., Groenhof F. et al. Skin lesions suspected of malignancy: an increasing burden on general practice. BMC Fam Pract. 2014; 15: 29. doi: 10.1186/1471-2296-15-29.

16. Pockney P., Primrose J., George S., et al. Recognition of skin malignancy by general practitioners: observational study using data from a population-based randomised controlled trial. Br J Cancer 2009; 100: 24–7. doi: 10.1038/sj.bjc.6604810

17. Order of the Department of Health of the city of Moscow from 15.01. No. 16 “On the provision of medical care in the” oncology “profile in medical organizations of the state healthcare system of the city of Moscow”. [Electronic resource]. URL: https://docs.cntd.ru/document/564221212 (Date of the application: 25.11.2021) [In Russian].

18. Argenziano G., Soyer H.P., Chimenti S. et al. Dermoscopy of pigmented skin lesions: results of a consensus meeting via the internet. J Am Acad Dermatol. 2003; 48: 679–93. doi: 10.1067/mjd.2003.281

19. Kittler H., Pehamberger H., Wolff K. et al. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002; 3: 159–65. doi: 10.1016/s14702045(02)00679-4

20. Tromme I., Sacré L., Hammouch F. et al. DEPIMELA study group. Availability of digital dermoscopy in daily practice dramatically reduces the number of excised melanocytic lesions: results from an observational study. Br J Dermatol. 2012; 167(4): 778-86. doi: 10.1111/j.1365-2133.2012.11042.

21. Piccolo D., Ferrari A., Peris K. et al. Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer-aided diagnosis of 341 pigmented skin lesions: a comparative study. Br J Dermatol. 2002; 147(3): 481-6. doi: 10.1046/j.1365-2133.2002.04978.

22. Garanina O.E., Samoylenko I.V., Shlivko I.L. et al. Non-invasive diagnostic techniques for skin tumors and their potential for use in skin melanoma screening: a systematic literature review. Medical Council. 2020; (9): 102-120. doi.org/10.21518/2079701X-2020-9-102-120 [In Russian]

23. Project «Personal Assistant» for patients with suspected cancer or with a confirmed diagnosis. [Electronic resource]. URL: https://www.mos.ru/news/item/88296073. (Date of the application: 11/20/2021) [In Russian]

24. Sergeev Yu.Yu., Sergeev V.Yu., Mordovtseva V.V. Melanoma of the skin in 2019: features of the clinical and dermatoscopic picture of the tumor at the present stage. Pharmateca. 2020; 8: 28-35. doi: https://dx.doi.org/10.18565/pharmateca.2020.8.28-35 [in Russian].

25. Haenssle H.A., Fink C., Schneiderbauer R. et al. Man against machine: diagnostic performance of a deep learning convolutional neural network for dermoscopic melanoma recognition in comparison to 58 dermatologists. Annals of Oncology. 2018; (0): 1–7

26. Zink A., Kolbinger A., Leibl M. et al Teledermatoskopie mittels Smartphone: Zuverlässige Hilfe bei der Diagnostik von Hautläsionen? [Teledermoscopy by mobile phones: Reliable help in the diagnosis of skin lesions?]. Hautarzt. 2017; 68(11): 890-895. doi: 10.1007/s00105017-4042-0.

27. Order of the Ministry of Health of the Russian Federation of 15.11.2012. No. 923 “On approval of the procedure for providing medical care to the adult population in the” therapy “profile. [Electronic resource]. URL: https://minzdrav.gov.ru/documents/9123prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot15-noyabrya-2012-g-923n-ob-utverzhdenii-poryadka-okazaniyameditsinskoy-pomoschi-vzroslomu-naseleniyu-po-profilyu-terapiya. (Date of the application: 25.11.2021) [In Russian].

28. Malishevskaya N.P., Sokolova A.V., Toropova N.P. Recommendations for dermatoscopy of skin neoplasms, protocol for dermatoscopic examination: a textbook for doctors. Yekaterinburg, SV. 2018; 23 p. [In Russian].

29. Sondermann W., Utikal J., Enk A. et al. Prediction of melanoma evolution in melanocytic nevi via artificial intelligence: A call for prospective data. Eur J Cancer. 2019; 119: 30–4. doi: 10.1016/j. ejca.2019.07.009

30. Hekler A., Utikal J., Enk A. et al. Superior skin cancer classification by the combination of human and artificial intelligence. Eur J Cancer. 2019; 120: 114–121. doi: 10.1016/j.ejca.2019.07.019

31. Glotsos D., Kostopoulos S., Lalissidou S. et al. Design of a decision support system, trained on GPU, for assisting melanoma diagnosis in dermatoscopy images. Journal of Physics: Conference Series. 2015; 633: 012079. doi: 10.1016/j.ejca.2019.07.019

32. Order of the Ministry of Health of the Russian Federation of June 2, 2015 N 290n «On the approval of standard industry standards of time for performing work related to a visit by one patient to a district pediatrician, a district general practitioner, general practitioner (family doctor), neurologist, otorhinolaryngologist, ophthalmologist and obstetrician-gynecologist «.[in Russian]. [Electronic resource]. URL: https://minzdrav.gov-murman.ru/documents/poryadkiokazaniya-meditsinskoy-pomoshchi/pr_MZ_RF_290.pdf. (Date of the application: 25.11.2021) [In Russian].

33. Doukas C, Stagkopoulos P, Maglogiannis I. Skin lesions image analysis utilizing smartphones and cloud platforms. Mobile Health Technologies. 2015; 1256: 435–458. doi: 10.1007/978-1-4939-2172-0_29

34. Grajdeanu I, Vata D, Statescu L, et al. Use of imaging techniques for melanocytic naevi and basal cell carcinoma in integrative analysis (Review). Exp Ther Med. 2020: 78–86. doi: 10.3892/etm.2020.8620.

35. Gaydina T.A., Dvornikova E.G. Efficacy of smartphone-compatible optical instrument for assessing melanocytic nevi for malignancy. Bulletin of RSMU. 2020; (5): 108–12. doi: 10.24075/brsmu.2020.065. [in Russian].

36. Sondermann W, Utikal J, Enk A, et al. Prediction of melanoma evolution in melanocytic nevi via artificial intelligence: A call for prospective data. Eur J Cancer. 2019; 119: 30–4. doi: 10.1016/j. ejca.2019.07.009

37. Hekler A, Utikal J, Enk A, et al. Superior skin cancer classification by the combination of human and artificial intelligence. Eur J Cancer. 2019; 120: 114–121. doi: 10.1016/j.ejca.2019.07.019

38. Doukas C, Stagkopoulos P, Maglogiannis I. Skin lesions image analysis utilizing smartphones and cloud platforms. Mobile Health Technologies. 2015; 1256: 435–458. doi: 10.1007/978-1-4939-2172-0_29

39. Grajdeanu I, Vata D, Statescu L, et al. Use of imaging techniques for melanocytic naevi and basal cell carcinoma in integrative analysis (Review). Exp Ther Med. 2020: 78–86. doi: 10.3892/etm.2020.8620.