Automated Analysis Applications

The purpose of these apps is to analyze data provided by the patient/user such as photographs. Since 2013, these apps are now regulated by the FDA. They typically use clinical and dermoscopic criteria such as the ABCD criteria, 7-point checklist, Menzies checklist, etc. to evaluate skin lesions and render a risk profile for the evaluated lesion. The automation of the visual examination has great potential. However, when only a selected few lesions (at the user’s discretion) are brought to medical attention, this may cause delay in the diagnosis of early subtle skin cancers that would otherwise be readily detected on a full skin exam. There are significant hurdles to successful automated diagnosis. Pictures may be altered by light quality, user expertise, and camera quality. Inaccurate diagnosis (especially in the context of limited to no history) could lead to a false reassurance and delay medical care. In addition, difficult to reach sites such as the back, buttocks, posterior thighs, and scalp may not get adequate attention from the user. Lastly, security of images, privacy of patient sensitive information, and false advertising remains a concern. Overall, these apps are useful but are not recommended to replace a physician rendered full skin examination for the reasons stated above.