Kosmet Med 2014. 34(6): 256 – 260

Use of melafind in the dermatologic practice
Die Anwendung des Melafind in der dermatologischen Praxis

Marcella Kollmann-Hemmerich^{1, 2}, Martin Nguyen¹, Norbert Blöhdorn-Schlicht³, Gerald Messer^{1, 2}

¹ Praxis für Dermatologie, Sendlinger-Tor-Platz 9, 80336 München
² Praxis für Dermatologie und Allergologie, Bauseweinallee 2, 81247 München
³ Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg

Key words: Malignant melanoma, diagnosis, automated diagnosis, dermatoscopy, biopsy

Summary:
Today, the diagnosis of initial malignant melanoma is one of the most important tasks for dermatologists, because an early diagnosis is the key for survival. The patients and health insurances are now more aware of screening of the skin for melanoma and the thickness at initial diagnosis has dropped. Today new methods are needed to help to find more initial tumours and to define dysplastic nevi in vivo. Remarkable progress has been made by use of dermatoscopic Evaluation and the method of computer-aided videodermatoscopy. Furthermore, the method of two-dimensional multispectral analysis (Melafind: 10 different wavelengths, 430 – 950 nm) of moles has emerged to a standard and has reached FDa clearance as well as CE clearance in the European union. Melafind creates information on size, pattern, pigmentation and dis-organization of the mole of 10 different layers and compares the data with a large data bank. as result a score is predictive for the risk for malignant melanoma.
We here present 4 patients with pigmented lesions in which Melafind was used. Prior to the multispectral analysis, a total body examination of the skin, dermatoscopic evaluation and videodermatoscopy was performed.
Other pigmented lesions than moles, e.g. pigmented sebaceous warts, should be excluded. Our first patient had a BK mole syndrome and the five most suspicious moles have been analysed by Melafind. The scores were low and no changes have been reported. thus, the patient will be monitored tightly. In two further patients, the clinical situation, dermatoscopic and Melafind analyses matched for initial melanoma and the lesion was excised. Difficult to diagnose within the group of pigmented lesions are the pigmented spindle cell nevus of reed and the juvenile melanoma of spitz.
As example, in our fourth patient the algorithm of Melafind was not indicative for an excision biopsy in a 5 year old boy. The histopathologic examination was consistent with nevus of Spitz.
In our hands Melafind serves very well in the differential diagnosis of moles, especially to diagnose initial malignant melanoma. Only dermatologists should use this valuable diagnostic tool carefully after clinical inspection and dermatoscopic evaluation. Melafind analyses the microarchitectural situation at 10 different levels of depth by multispectral photometric data and combines the findings with computer based data. this provides a novel and independent standard helping the dermatologist to decide, whether or not an excision of suspicious moles for initial malignant melanoma should be performed.