Why Sooner is Better

Early detection of melanoma may help minimize the invasiveness of treatment—and it can be life-saving. This is why Dr. Markowitz is an advocate of routine skin exams to spot skin cancer in its earliest stages.

The Downside of Over-Diagnosing

To diagnose melanoma, however, many doctors today rely heavily on their scalpels, cutting out every suspicious spot and sending it to a lab to be diagnosed. The result: A patient’s skin can become pockmarked with incision scars.

“I call it Swiss Cheese Syndrome,” says Dr. Markowitz. “I believe there is far too much unnecessary cutting going on right now. I would even go so far as to say the over-diagnoses of melanoma is reaching epidemic proportions.”  

The authors of a recent article “The Rapid Rise in Cutaneous Melanoma Diagnoses,” published in The New England Journal of Medicine, concur. The article asserts that the primary reason melanoma diagnoses have increased six-fold in the past 40 years is the dramatic increase in the number of biopsies, not because people are developing melanoma at a greater rate. It is also worth noting that the increase in biopsies has not decreased the melanoma mortality rate.

Is There a Better Way?

Dr. Markowitz has long maintained that aggressive biopsies are not the only—nor even the most accurate—way to diagnose melanoma. Using her arsenal of state-of-the-art noninvasive tools, Dr. Markowitz is able to detect and study the skin at a microscopic level, greatly reducing the amount of healthy skin damaged by unnecessary cutting. Even better, Dr. Markowitz’s noninvasive methods boast a diagnosis accuracy two times the average biopsy. “With recent noninvasive innovation, I am also comfortable leaving borderline spots on people's skin because I have safe, reliable methods to monitor those lesions, well before they would develop into skin cancer,” says Dr. Markowitz.

Dr. Markowitz’s Spare-the-Scalpel Strategy

To examine the skin for melanoma sans scalpel, Dr. Markowitz uses this lineup of tools:

• Dr. Markowitz examines every skin lesion with a handheld microscope called a dermatoscope. If a suspicious lesion has a few atypical features, she will usually take images of the spot and ask the patient to return in three months for another look.  

• If the lesion merits closer study immediately, Dr. Markowitz will examine it using reflectance confocal microscopy (RCM), a tool that enables her to get microscopic cellular resolution of the skin.

• If the confocal image does not suggest melanoma is present but there is still some atypical features, for further certainty, Dr. Markowitz will use DermTech’s Pigment Lesion Assay (PLA) tape-strip test to confirm. “Without any cutting, this innovative test can rule out melanoma with 99 percent certainty,” she says. How it works: The adhesive on the tape removes 1.5 mg of tissue from the top layers of the skin, without any damage to the site. The tissue is then sent to DermTech’s Gene Lab in California, where it is examined and diagnosed.

• Finally, if melanoma is diagnosed, Dr. Markowitz will utilize optical coherence tomography (OCT) to determine the exact size and depth of the skin cancer, helping to minimize the amount of cutting necessary to remove the melanoma.

Call OptiSkin today

If you are concerned about a spot on your skin—or have any melanoma risk factors—alleviate your worry by scheduling a skin exam with Dr. Markowitz as soon as possible. Remember: When caught early, melanoma is highly treatable.