The Waldman Melanoma and Skin Cancer Center offers the most up-to-date diagnostic methods available. Few centers can match the variety of tools that we use to arrive at a comprehensive, accurate evaluation of your skin’s health. The first line of defense, however, is your own regular self-examination of your skin.

How to Examine Your Skin

It’s important to do a regular, thorough self-examination of your skin. Notice any new spots on your skin, or spots that are different, have changed, or are itching or bleeding. Use a full-length mirror and examine yourself all over, front and back, as well as both sides with your arms raised. Be thorough:

• Look at your underarms, forearms, and palms
• Look at your legs, between your toes, and soles of your feet
• Use a hand mirror to check your neck and scalp
• Use a hand mirror to look at your back and buttocks

If you notice any changes, be sure to make an appointment with a dermatologist.

Your Dermatologist Appointment

Regular dermatologist appointments are important, especially if you’ve spent a lot of time in the sun. Your dermatologist will gather information in a variety of ways to make a diagnosis. Your doctor may begin by asking questions about symptoms (such as changes in the spot’s appearance and whether it hurts or itches) and risk factors (such as family members with skin cancer and any history of sunburns).

Your doctor will also conduct a physical exam that will include looking at the lesion, checking the rest of your body for similar marks, and possibly feeling your lymph nodes, which become enlarged if the cancer has spread. Dermatologists may also use a dermatoscope—a small, lighted magnifying instrument—to better see a certain area.

If your doctor suspects you have a skin cancer, they may perform a biopsy in order to make a diagnosis and—if skin cancer is present—begin the treatment process.

Skin Biopsy

There are several different methods to obtain a skin sample to test for cancer, all of which can be done in a doctor’s office. A shave biopsy takes a thin layer of skin. A punch biopsy extracts a small, round sample of skin. An incisional biopsy is when your doctor takes a small sample using a scalpel. Before the procedure, the area is numbed with a local anesthetic. With some punch and incisional biopsies, you may get stitches. You may experience some soreness for a week. And sometimes, a biopsy may leave a small scar.

Our State-of-the-Art Diagnostics

The Waldman Center also offers the latest advances in detection and diagnosis—many of which are less invasive than biopsy. We make every effort to spare discomfort and avoid appearance-altering procedures—yet provide highly accurate, reliable testing.

3D Total Body Photography

The Waldman Melanoma and Skin Cancer Center is one of the few facilities in the world to offer digital 3D total body photography to detect skin cancer. The Vectra WB180 machine takes 92 photographs of the patient at once and compiles them into a 3D model of the patient. The model serves as a baseline against which changes in growth or pigmentation in the future can be analyzed. The system catalogs the growths or lesions by size, shape, and/or color.

Two-dimensional total body photography has been in use since the 1990s. However, the process is slow and often uncomfortable for the patient. The Vectra WB180 machine can generate a full body scan in less than a minute. The result is a more pleasant and quicker examination experience for the patient, and a more efficient and accurate result for the physician.

Reflectance Confocal Microscopy

Reflectance confocal microscopy is an innovative imaging tool that allows your doctor to see deeper into the skin without cutting. It enables physicians to monitor and diagnose a variety of skin conditions and lesions, including skin cancer. Low-powered laser beams penetrate down to the skin, and the reflected image is as precise as looking through a microscope. This procedure spares many patients the need for a biopsy, especially when the diagnosis is uncertain. The procedure is painless, and takes approximately 15 minutes.

Optical Coherence Tomography

Optical coherence tomography (OCT) is a noninvasive imaging technique that uses low-power infrared laser light to provide images of growths or lesions below the skin’s surface. OCT imaging is similar to ultrasound except that it measures the bouncing back of light, rather than sound. This technique builds 3D images by recording the length of the path that photons travel. It allows your doctor to examine growths at even deeper levels than confocal microscopy. However, it is not suitable for evaluating pigmented growths. Like confocal microscopy, OCT can eliminate the need for biopsy. And because of the precision of its imaging capability, it is especially useful in guiding Mohs surgery, which involves removing skin cancer layer-by-layer, allowing for smaller excisions.

Electrical Impedance Spectroscopy

Another innovative diagnostic tool, especially useful in detecting melanoma, is Nevisense™, the electrical impedance spectroscopy developed by Scibase. This painless, noninvasive technique measures the electrical conductivity through the skin. Abnormal growths and lesions conduct electricity differently than normal skin. A computer program analyzes the results and provides valuable diagnostic information, not available through other methods. The Nevisense method is particularly effective in evaluating pigmented skin lesions for melanoma.

Gene Expression Testing

The Waldman Center offers several types of gene expression testing—a form of personalized medicine—to detect melanoma and predict whether it will spread. The DermTech test is used to detect melanoma without the need for a biopsy. A sticker gently removes skin cells, which are tested for elevated levels of specific genes that indicate melanoma. The test is 99 percent accurate, and spares patients the need for a surgical biopsy.

The DecisionDx-Melanoma test is used for Stage I and II melanoma patients. These tests are done on cancerous cells taken during biopsy or surgery to examine the patterns of different genes. From these tests, we can reliably predict which patients are at risk for the spread, or metastasis, of the cancer.