Total Body Photography (TBP)
In July 2010, we engaged Canfield Scientific's Derma-Trak Imaging Systems, probably the most highly respected Total Body Photography (TBP) providers in the country, to come to our conference in Texas and make this service available to anyone in attendance. TBP is a medically prescribed procedure which dermatologists use to help them keep track of the appearance of facets of the skin. In the case of large nevi, which are supposed to be "watched for changes," photography is currently considered the best way you can tell if a pigmented lesion has changed.
Why do we need TBP?
We felt this was important for two reasons. First, we did not have any medical research-worthy collection of suitable images of people with nevi in our repository, but we thought we should; we could very well need a resource like this for future nevus-scientific endeavors. Second, this procedure is notoriously difficult to get insurance to pay for. The doctors prescribe it since it is important for people affected by large nevi, but if insurance won't cover it, patients will most likely not have it done.
With our need for research-grade resources and the patients' need for relief from insurance nightmares, we felt it made sense to make this service available to anyone coming to our conference, in exchange for their allowing us to include their images in our data repository.
Before the 2010 conference, we set as our goal to photograph 10 patients. When the dust settled, we had photographed 68 patients! We were so encouraged by the support of all these patients, that we continued to offer this service at our meetings in 2012 and 2014. As of this writing, we have photographed over 100 patients, and some of them multiple times over a number of years.
The very first scientific use to which we have put the photos came out of the Nevus Outreach-sponsored 2011 International Expert Meeting on Large Congenital Melanocytic Nevi and Neurocutaneous Melanocytosis in Tübingen, Germany. A team of physicians there, headed by Dr. Sven Krengel, wished to design a new system to describe congenital nevi in a more organized and systematic way.
Our team has published this new classification system after using the photographs of many of our patients as test examples. The question would be, could we increase the level of consistency in the descriptions when two different physicians look at the same patient? After confirming that this goal would be accomplished by using the new classification system, it has been published again.
Now that we have such a large pool of photographs, all of which have been made using the same equipment under the same conditions, the next step will be to find ways to use the photographs to improve the care of patients affected by congenital melanocytic nevi. Imagine, for instance, how diagnostics could be improved if we can analyze data derived by analysis of these high-resolution digital photographs. If we can measure, for instance, the body surface area that a nevus covers, and count the number of satellites with much greater accuracy than we do at present, or degree of hair growth, or a metric for texture or color, we may be able to more correctly predict risk factors for melanoma and neurocutaneous melanocytosis.
On behalf of all of us at Nevus Outreach, we wish to thank all the patients who have participated in the project, and we encourage all people affected by congenital nevi to participate in future opportunities for total body photography.
The Total Body Photography project at the 2010 Nevus Outreach Conference was an unprecedented success. While we had hoped to get photos of 10 patients, we ended up with 68! It took a little extra time to process so many, but with the help of our hard workers, we have sent the results out to all participants. Since then, we have offered this service at both the 2012 & 2014 conferences, & to date, we've photographed over 100 patients.