Skin cancer - Standardized assessment through digital technology

What is skin cancer?

Skin cancer, the abnormal growth of skin cells and usually develops on sun exposed areas of skin, however it can also occur on areas of your skin not ordinarily exposed to sunlight. Skin cancer affects people of all skin tones, including those with darker complexions. The first sign of non-melanoma skin cancer is usually the appearance of a lump or discoloured patch on the skin that persists after a few weeks and slowly progresses over months or sometimes years.

There are two types of non-melanoma skin cancer - basal cell carcinoma and squamous cell carcinoma.

• Basal cell carcinoma (BCC), also known as rodent ulcer, starts in the cells lining below the epidermis. It usually appears as a small, shiny pink or white lump with a translucent appearance. The lump often gets slowly bigger and may become crusty, bleed or develop into an ulcer. BCC does not usually spread to other parts of the body.
• Squamous cell carcinoma (SCC) starts in the cells lining on top of the epidermis. It appears as a firm pink lump with a rough surface. The lump often bleeds, and may develop into an ulcer as well. There is a small risk of SCC to spread to other parts of the body.

The incidence of both non-melanoma and melanoma skin cancers has been increasing over the past decades. Currently, about 2-3 million non-melanoma skin cancers occur globally each year. BCC and SCC of the skin make up 99% of all non-melanoma skin cancer cases, with BCC being 3 to 5 times more common than SCC.

Family history, pale skin, the presence of moles and freckles, having light coloured hair, older age and having a condition that suppresses the immune system are all among factors which can increase the risk of developing all types of skin cancer.

Traditional assessment methods of non-melanoma skin cancer lack objectivity

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Assessing non-melanoma skin lesions is a routine part of general practice. Traditional assessment methods include the use of the non-invasive method, dermoscopy and the invasive method, biopsy. These techniques provide the required information, however they can be time consuming. Furthermore, conventional assessment methods do not provide a standardized method for documentation of skin changes, which would have the potential to enable a more effective assessment and monitoring of any suspicious changes on the skin surface.

BCCs rarely require staging given their minimal potential for metastasis. However, cutaneous SCC has a 4% annual incidence of metastasis, so staging is vital to its management and treatment. The staging system of SCC, by the American Joint Committee on Cancers (AJCC) and the International Union Against Cancer (UICC), is continuously being updated to meet current data, however it has limitations.

With a rapidly rising incidence of non-melanoma skin cancer, an increasing number of patients are referred to dermatologists for evaluation of lesions suspicious of skin cancer or pre-malignancies. A disease management system that provides a new and more effective skin cancer management strategy is needed to provide adequate assessment, monitoring and define treatment plans for skin cancer patients. The burden on the healthcare system will be reduced in response to improved screening methods.

Therefore, a technology which would deliver an objective and standardized method of documentation of any changes on the skin surface is of high demand for professionals and the healthcare system itself.

Digital standardized assessment

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In a clinical setting, having a reliable, accurate and comparable method for the assessment of a disease, such as skin cancer, has utmost importance. SCARLETRED is introducing standardization and objectivity in the process of skin imaging and assessment.

Scarletred®Vision automatically standardizes the acquired images taken with the app, overcoming inaccuracies resulting from the subjectivity of the currently available assessment tools and methods. In this way, this technology not only increases the efficiency and reliability of the assessment procedure while saving time, but also allows the patient to visually document the skin area of interest remotely from their own home. Due to compliance to the highest international standards, it is a software well accepted by regulatories for usage in clinical trials worldwide.

The platform functions as a secure documentation tool providing objective measurement and monitoring of melanoma or suspected moles through the integrated remote data monitoring level and built-in service tools. For the documentation and assessment of BCC and SCC, color quantification is important as color and diameter changes can be objectively analysed and measured for non-melanoma skin cancer cases. Color quantification of skin changes or lesions is based on the objective visual information obtained from the Scarletred®Vision app.

Early diagnosis for skin cancer patients is crucial to improve prognosis and treatment efficacy, therefore having a reliable assessment method is fundamental for the assessment and monitoring of suspicious changes on the skin surface or pre-malignancies as well as it can contribute to a more effective documentation of the skin changes or lesions. SCARLETRED´s digital technology delivers an objective solution to overcome some of the limitations exposed by traditional assessment methods for non-melanoma skin cancer in regards to objectivity of documentation and assessment.