MEF’s Focus on Education Over Research

When we began the Melanoma Education Foundation (MEF) in 1999, we briefly considered throwing our support to the research side of skin cancer. However, we ultimately concluded that for us specifically, the best way to make a difference was to focus exclusively on melanoma education. We’ve maintained that focus for over 18 years, and the results of our efforts continually prove that we made the right decision.

Why Education?

The MEF was created by our founder after he suffered the tragic loss of his son Dan to melanoma at 26 years of age. As we began reaching out to other victims of this disease and their families, we quickly became aware of a few very disheartening truths. Most melanoma patients possessed little-to-no knowledge about the affliction prior to developing it or, even worse, until it progressed too far to stop.

Moreover, we discovered that most middle and high school health and wellness educators were also uninformed about melanoma. As such, they don’t ever mention anything about it in their health classes. That is a huge opportunity lost, because the odds of developing melanoma skyrocket in our mid-20s. How can we expect children and adolescents to understand (or to simply be aware) of the risks associated with exposure to the sun’s harmful UV rays if they’re not provided with the information?

The Choice

Research is a short word with a chasm full of different definitions; particularly when it’s associated with medical science. We wanted to accomplish as much as possible with our limited finances, and we had a choice. We could’ve given our support to “research”, but to be honest what does that even mean? Does anyone who’s ever dropped a dollar into a store’s countertop jar to benefit a given disease know where that money goes? Or how much of that dollar will actually get to where it’s most needed? Sure, it feels good but there’s nothing tangible about it. You don’t even really know how much of a difference you’ve made, if any. Even worse, you’ll never know.

Like the legendary Jonas Salk, the medical scientist who rid the world of the scourge of Polio, sooner or later some group of scientists working for some massive pharmaceutical company are going to take down melanoma. But what if it’s later rather than sooner? And what about all the melanoma victims who’ll die in the meantime of a disease they could’ve easily avoided had they only known? What we could contribute to the development of new skin cancer medicines and technologies would be akin to tossing a Dixie Cup full of spring water into Lake Superior.

On the other hand…

What if, instead, we directed our attention to reaching teachers about the importance of melanoma education in the classroom? If successful we could make a tremendous difference through bypassing the post-acquisition treatments and cutting skin cancer off at its’ source.

There’s infinite wisdom in the old adage ‘An ounce of prevention is worth a pound of cure’. And over these last 18 years we’ve exceeded our greatest expectations. The melanoma lessons our website offers are now being taught in over 1,700 middle and high schools spread across 49 U.S. states.

What helps is that, as deadly as it can be, melanoma has a few vulnerabilities that are easy to exploit- and also easy to instruct others about. If caught early enough, a simple doctor’s office excision carries a 98% cure rate. And melanoma is one of the few potentially fatal diseases that loudly announces itself ahead of time with skin changes, blemishes and discolorations. These can then be found during a short, monthly skin self-examination.

We’ve taken numerous surveys and have had countless conversations. And we’ve heard time and time again from students, teachers and our website’s visitors that they’ve all found early melanomas they would not have paid any attention to were it not for their MEF education.

One day, melanoma will be swept away into the dustbin of medical history where it belongs…

…but until that joyous day comes, we will continue to honor Dan- and the millions like him -by aggressively working to deny skin cancer as many victims as we possibly can.

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Can Smartphone Apps Detect Melanoma?

Smartphones Preparing to Take on Skin Cancer

For thousands of years, humanity’s progress in the fields of medicine and technology moved along at a glacial pace. That lack of speed is now, quite literally, ancient history. Today’s scientists and physicians are making advancements, improving diagnostic instruments and developing new treatments at seemingly the speed of light. No sooner does one breakthrough occur than it’s quickly replaced by an even better, more effective one.

There is perhaps no greater cause for excitement than when new scientific technology is married to some aspect of medical science. And it appears that we may right now be on the cusp of another such achievement. It concerns the all-important early detection of potentially fatal melanoma; the deadliest form of skin cancer.

Can Smartphone Apps Detect Melanoma?

A group of scientists based out of California’s Stanford University have created an extraordinary smartphone app. It employs artificial intelligence that allows a smartphone to “view” uploaded pictures of moles and skin blemishes; and then determine whether they’re skin cancer. In ongoing trials the app has shown itself to be remarkably accurate.

Imagine the positive impact such a device would have for people who live in sparsely populated regions and areas without easy access to a dermatologist. Or those with low incomes and little-to-no medical insurance.

Theoretically, the app would inform its user if skin cancer or melanoma has been detected, and at that point he or she could quickly make a dermatological appointment. If a mole is benign, it saves the person from unnecessary travel costs and medical bills.

However, it’s important to note that the future has not yet arrived. As promising as this technology is, it’s not yet been perfected. In fact, two years ago the Federal Trade Commission (FTC) admonished both Mole Detective and Mel App for false advertising when neither company could offer scientific proof to substantiate their promotional publicity statements.

If you do decide to give this technology a try, an app like SkinVision will allow you to store multiple images of your mole or blemish. This allows users to chronicle any changes that can later be easily produced for their dermatologists. This is of a greater benefit than an occasional, self-visual observation.

Drawbacks

Unfortunately, it’s possible for even the most experienced dermatologist to be tricked into thinking a nodular melanoma is benign after a single visual appraisal. As such, it’s unreasonable to expect that a smartphone app will always provide a correct assessment after analyzing a single image.

Doppler: Not Just for Predicting Weather

Aside from the general anxiety caused by the thought of potentially receiving an unwanted diagnosis, many people put off scheduling skin exams due to an expectation that some element of pain will be involved. First, a routine skin exam is non-invasive. A doctor or dermatologist will look you over and, if necessary, use a special magnification instrument to check any suspicious moles up close.

When melanoma is suspected, the next step is to excise the affected area and have the tissue biopsied by a pathologist. However, Lancaster University scientists have created a new, painless way to test; best described in this direct quote from the cited ScienceDaily.com article:

Researchers have developed a new non-invasive technique which can accurately detect malignant melanoma without a biopsy. Their report shows that a special technique using a laser to detect the subtle differences in blood flow beneath the skin enabled researchers to tell the difference between malignant melanoma and non-cancerous moles.

The laser referenced is called a Doppler Laser.

Of course, nothing is better for our overall skin health than an examination by a fully-qualified dermatologist. But due to the vital importance of a quick skin cancer diagnosis, once ready these highly-convenient tools could turn out to be real life savers.

*Additional source articles: Health.good.is, Consumerist.com, CNN.com, ScienceDaily.com

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Unlike melanoma, Squamous Cell Carcinoma (SCC) (SQUAY-muss) is a fairly-common type of skin cancer that is not typically fatal. Just like melanoma though, if it’s left undiagnosed, it too can turn lethal.

Squamous Cell Carcinoma can originate in any of the body’s numerous squamous cells. You may not be too surprised to learn that those cells are where this form of skin cancer gets its name. As with many such cancers, its primary cause is overexposure of unprotected skin to the sun’s harmful UV rays.

It can also be developed after tanning bed use. As an aside, there are no words strong enough to sufficiently emphasize the importance of avoiding those beds. This also includes lamps used for things like securing gel nail polish. Any commercial use of artificial UV light is a 100% Risk-0% Reward activity. Any dermatologist will attest that that is not in any way hyperbole.

SCC usually develops on the areas of our skin that are most likely to incur unprotected sun exposure; such as on the scalp, ears, lips and the backs of hands.

How deadly it might become can also be determined by the area on which it begins. The mortality rate climbs when it’s located on the lips, in the mouth, over the carotid artery, or on skin covering internal organs such as the lungs.

As with melanoma, SCC can present with a variety of appearances. However, what it looks like most often is a slightly raised red patch that becomes rough, dry and scaly.

Presented below are two pictures. On the left is an example of SCC. The picture to its right depicts Actinic Keratosis, which we’ll discuss shortly:

 

 

 

 

SCC is generally a slow-growing skin cancer; except when it initiates on the lips or in body parts containing mucous membranes.

Here is a photo of SCC developing on lips:

 

 

 

 

 

Actinic Keratosis

Actinic Keratosis (AK) is a pre-cancerous lesion that takes decades to fully develop and rarely progresses to SCC. You’ve likely seen it many times on the middle-aged and, more particularly, the elderly.

At the risk of sounding like a broken record, AK, too, is caused by UV ray exposure.

Of course, these lesser-afflictions also serve to highlight just how many different forms of skin damage our sun can- and does -inflict upon us.

Currently there are multiple effective non-surgical treatment options for treating AK and early stage SCC. Among the most common of these is freezing them off.

One terrific way to avoid dealing with SCC, AK and every other skin cancer you’ve read about on our previous blogs, is to simply not get them to begin with. Protect your skin; protect your life.

*Additional source articles: Mayoclinic.org, Mayoclinic.org

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Skin Cancer Education Re-imagined

The Melanoma Education Foundation (MEF) has been making great strides throughout the United States with its middle and high school-focused skin cancer lessons. Our most recent figures show that they’re used in over 1,700 different schools; spread out over every U.S. state but one. We would very much like to keep that ball rolling. (A link to a list of those schools, as well as to actual teacher testimonials, are both provided below)

If you’re a pre-teen or adolescent health and wellness educator, we encourage you to review and present these highly-informative lessons to your classes. They are designed to be efficient, easy-to-use, and require virtually no prep work. Even better, they fit entirely into a single class period with plenty of time to spare.

Registration is easy and completely free. To do so, simply click right HERE and you’ll be directed to our melanomaeducation.net website. Both the short student and teacher-training videos you’ll receive post-registration access to have won the prestigious Gold Triangle Award from the American Academy of Dermatology. (AAD)

Now let’s go a little more in-depth into why these lessons are so valuable to both you and your students. Teacher surveys taken after in-class presentations of the MEF lessons reveal that due directly to them, many early melanomas were discovered by students, teachers and family members.

That is crucial, as in its earliest stages melanoma has a cure rate of nearly 100%. The more time that passes between its development and diagnosis, however, allows for the continual increase of the odds that it will become fatal.

The MEF high school lesson is currently the only one that specifically addresses nodular melanoma. Melanoma is the worst form of skin cancer, and nodular is the most lethal type of melanoma. Even worse, teenagers are particularly vulnerable to nodular, which unfortunately doesn’t typically show any of skin cancer’s familiar ABCDE signs. (A= Asymmetry, B= Border, C= Color, D= Diameter, E= Evolving)

MEF also differs from other skin cancer lessons by providing more comprehensive information, which in turn leads to more effective results. Most non-MEF lessons continue to direct their primary focus on sun-safety. They do this despite the plentiful data garnered from numerous studies that show emphasizing sun-safety has little-to-no effect on altering teen behavior patterns. In other words, teens essentially ignore it.

This approach also prevents teenagers from learning the critical fact that 30% of melanomas are not even caused by UV ray exposure. Among other risks, not having that knowledge may cause students who aren’t into tanning to skip regular skin-self exams; thinking they need not bother.

To all the health educators within sight of these words, please consider employing our lessons. The more schools that incorporate their usage, the more young lives we can all save together.

Please click to view a variety of teacher testimonials

Please click to view the list of schools using the MEF skin cancer lessons

To visit our websites, please click: skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Test Your Melanoma Knowledge

We’ve taken a slightly different approach with today’s blog post than what you have (and will) usually see from us; but it’ll be fun and educational.

We have prepared for you a brief, visual quiz. It’s specifically designed to demonstrate that judging a skin growth on its looks alone is simply not enough. It’s vital to regularly keep tabs on every inch of your skin, and be wary of any changes to new or existing moles that have been progressing for more than two weeks. And that’s regardless of its appearance.

Presenting the Quiz

Below, you’ll see a photo containing six numbered images of various skin growths. Three of them are benign (non-cancerous) and three are melanomas (very cancerous).

Please choose which three you believe to be the melanomas. At the very end of this post you’ll be able to view the answer key, along with the name and a description for all six images. Good luck!

The Images:

1                     2                       3

 

 

 

 

4                       5                      6

Regardless of your score, (which you’ll learn shortly) please remember what’s most important is that you’ve just helped educate yourself about melanoma! You now have information that could possibly one day help to save a life.

We very much encourage you to share this quiz with your friends, family and social media followers.

So, how did you do on our quiz? Numbers 3, 4 and 6 were the melanomas.

Here is some information about all six photos:

Their Descriptions:

  1. Lentigo. (Benign) Better known as age or liver spots, they are very common on older individuals who’ve had excessive sun-exposure.
  2. Raised mole. (Benign)
  3. Melanoma. (Malignant)
  4. Melanoma. (Malignant) Although it appears to be a normal mole, during his annual dermatology exam this patient asked his dermatologist about it and was told it was ordinary and benign. After explaining that it had been steadily increasing in size over a period of months, he requested it be excised and biopsied, anyway. The pathology report returned with a diagnosis of early melanoma. It’s for reasons like this that performing a regular self-skin exam is crucial. Regardless of a dermatologist’s ruling, patients who still have doubts, or who are left unsatisfied, must advocate on behalf of their own good health.
  5. Blue Nevus. (Benign) It carries no more risk of becoming a melanoma than any other mole does.
  6. Amelanotic (flesh colored) Nodular Melanoma. (Malignant)

*To visit our websites, please click: skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

What to do if a Suspicious Growth is Found During a Skin Self-exam

One of the major tenets essential to melanoma education is for everyone to perform regular skin self-examinations. All it entails is a few minutes once a month during which you simply check over your skin from head to toe. (And palms to soles).

No surface area of the body, nor inside the mouth, is to be excluded. A close friend, loved one or doctor can check the places you can’t; such as the back, scalp, neck, and inside and around both ears. (For information regarding the two types of melanoma, radial and nodular, please click HERE).

If your completed skin self-exam reveals nothing unusual, that’s excellent. However, if a suspicious new mole, or changes to a pre-existing one is discovered, the time to act is right away.

My Self-exam has Revealed a Suspicious Mole. What do I do?

It’s likely that your first instinct would, understandably, be to contact your general practitioner. However, call a dermatologist instead. Most family doctors receive minimal, if any, dermatological training while attending medical school. This leads to melanomas being missed or misdiagnosed in their earliest stages, which is the most crucial time to confirm them.

Some insurance companies require a referral from your primary care physician. If yours is among them, request that he or she quickly provide you with one.

What if There is a Long Wait for a Dermatologist Appointment?

If you encounter the hurdle of a weeks, or even months-long wait before a dermatologist can see you, you still have multiple choices. Contact the office and explain that the skin growth you’ve discovered resembles a melanoma, and that you don’t want to wait. You can also ask them to call you first if a previously scheduled patient cancels an appointment.

If you’re unsatisfied with what the dermatologist’s offices tells you, make an appointment with a plastic or general surgeon. Their qualifications to excise new melanomas are equal to those of dermatologists. You can often get in to see them sooner, too.

The one option to absolutely avoid is to make a distant appointment, and then just wait around for it. In the financial world, the old saying is time is money. In the world of melanoma, it’s time is mortality.

The procedure to remove an early melanoma isn’t difficult or time consuming. In fact, if it is a melanoma that has been caught soon enough, its quick removal is often the cure itself. And once the growth has been excised, be sure to instruct the surgeon or dermatologist to have a dermapathologist (rather than a general pathologist) perform the biopsy. He or she will have greater training and experience with distinguishing the subtle nuances that often occur between a benign mole and actual skin cancer.

In the 18 years since the Melanoma Education Foundation was created, no one within the organization has ever encountered a single person who has ever regretted the removal of a suspicious skin growth.

So please, don’t be shy and do be persistent. Remember, it may very well be nothing. But if it is melanoma any delay in diagnosis will increasingly begin to put your life at risk.

*Additional source: Skincheck.org(Page 5)

To visit our websites, please click: skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

SPF is Far Less Important than How Much is Applied

Anyone with even the most basic awareness of skin cancer is likely to know that the Golden Rule of practicing sun-safety is to wear sunscreen. The only better protection from the sun’s harmful UV (ultraviolet) rays is to sit inside your home with all the window shades drawn.

Unfortunately, though, there is a key piece of information regarding sunscreen of which far too many people are unaware.

Get the Maximum SPF Out of Your Sunscreen

First, if you’re a regular sunscreen user- excellent job. However, it’s equally important to apply the correct amount. This is the only way to ensure that the sun protection factor (SPF) sun-shield that you’re actually receiving is identical to what is stated on the product.

Many of us, albeit unwittingly, fall into that category. The typical wearer applies a mere 25% of what’s required to achieve a sunscreen’s full safety potential. And while 75% off may be fantastic for department store sales; it is disastrous to our skin. To illustrate further, when 25% of an SPF 100 rated sunscreen is applied, the true SPF isn’t 25- it’s only 3.2.

Anyone who spends even a brief time reading up on skin cancer and melanoma, will inevitably come across a few of the same specific comparisons used in a wide variety of materials. The one relevant to this post is that the minimum volume of sunscreen to use for each application would be enough to fill a shot glass. It’s also important that it be evenly distributed across any exposed skin, and be re-applied at a maximum of two hours. Even sooner than that if you’ve been sweating or swimming.

Speaking of the latter, spending a day at a beach or pool wearing only a swimsuit is not a good idea. However, anyone who does should use up an entire a 6-ounce container of sunscreen on him or herself by the time they leave. Do you use that much or know anyone who does?

The main point is important to reiterate: you must apply sunscreen much more heavily than that of most users to achieve the rated SPF.

Don’t just get your money’s worth of SPF; get your skin’s good health worth.

*Additional sources: Vitals.lifehacker.com, Onlinelibrary.wiley.com

*To visit our websites, please click: skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Teacher Survey Confirms Effectiveness of Melanoma Lessons

Nothing is more important to the Melanoma Education Foundation (MEF) than educating people on how to prevent themselves from developing this disease; especially adolescents and teens. Also, to inform them about what to look for, and then how to proceed if a melanoma is discovered.

We believe the best way to accomplish our goals is to provide melanoma and skin cancer instruction materials, information and encouragement to the teachers and parents of these students.

Among these items are our highly-enlightening website melanomaeducation.net, and brief, three minute introductory YouTube video. It discusses the effective MEF lessons currently being taught by health and wellness educators in middle and high schools across the United States. (If you’d like to view that short YouTube video now, simply click HERE).

Recently, MEF founder and president Steve Fine was presented with a unique opportunity to gain significant insight into the MEF initiatives.

For a project assignment, a bright, young Emerson College Applied Learning Experience (ALE) student named Marissa Picerno created a web-based survey. Its purpose was to measure how effective the Foundation’s lessons have been.

365 teachers responded to the approximately 1,300 survey invitations that were sent out. The results were illuminating- and very encouraging. We’d like to share with you a few examples.

  • 94% of the teachers either agreed or strongly agreed with the question, “Do you think the online melanoma lessons have changed your students’ perception of melanoma?”
  • 23% responded that, due to the MEF lessons, they or a family found a melanoma or other type of skin cancer. That number translates to nearly 80 people who otherwise may not have caught their cancers.
  • After being shown the lessons, the teachers stated that nearly 300 students would use more sunscreen, and over 200 would stop using tanning beds. That is tremendous; tanning beds are a figurative cancer on society, and a literal one on their users.
  • 319 teachers out of 332 replied that they view the lessons as either favorable or highly favorable. We’ll let those number speak for themselves.
  • 313 out of 334 educators said that their students’ attention spans during the lessons were either good or excellent.
  • 225 answered yes, they or a family member had been examined by a dermatologist due to the lessons.

These numbers are fantastic; they validate the effectiveness of the melanoma lessons. Moreover, they can also be used as a tool to recruit additional health educators into the program. Each one who opts to participate carries with him or her the potential to save multiple lives.

We would also like to offer a special thank you to Marissa for her hard work and her dedication to the Cause.

*To visit our websites, please click:  skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Normal Moles vs. Atypical Moles

When a person begins educating him or herself about melanoma, some of the first relevant information they’ll come across will be on moles. They’re very important, as 90% of all melanomas begin on the skin and pretty much everyone has them.

Although you’ve surely seen them countless times, you may not be aware that there are two types: normal moles, and atypical moles. (Officially, dysplastic nevi).

Atypical moles have a much greater chance to develop into melanoma than do normal moles. The odds are about 1 in 100 with the former; yet fewer than 1 in 3,000 with the latter. Those who have an atypical mole(s) carry a stronger risk of melanoma. Incidentally, the appearance of hair on any mole is medically irrelevant. It carries no weight with regard to an increased risk of skin cancer.

No one should ever try to tell the two apart without a biopsy; as even a dermatologist cannot be certain without one. However, they do have some distinguishing characteristics that (in general) helps to tell them apart.

For instance, normal moles maintain the same color (most often brown), are round, oval, and sometimes domed in shape. They have well-defined borders and are less than a quarter-inch wide.

These are two examples of normal moles, both raised and flat:

 

 

 

 

Atypical moles are wider than a quarter-inch and may be multi-colored (brown or pink). They have uneven borders and an irregular shape. Raised dysplastic nevi display a “fried egg” look.

These are two examples of atypical moles, both raised and flat:

 

 

 

 

One thing they both do have in common is that their surface areas are usually smooth or cauliflower in texture.

Familial Atypical Mole Syndrome

Familial Atypical Mole Syndrome is a disorder that is passed along through our genes. If any close relatives (immediate family but also including grandparents, uncles and aunts) have or have had melanoma and if a large number of atypical moles are present, there’s a high risk of developing the disease.

While monthly self-examination is important for every person of either gender, all races and skin tones, it’s even more vital to those with Familial Atypical Mole Syndrome.

These is an example of Familial Atypical Mole Syndrome:

 

 

 

*Additional source articles: Cancer.gov, Emedicine.medscape.com

To visit our websites, please click:  skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

 

 

 

 

 

Appearance Limitations in the Self-Detection of Melanoma

You’re probably already familiar with the saying, looks can be deceiving. Well, that old proverb becomes somewhat more tangible when it’s applied to the subject of melanoma.

What Does Melanoma Look Like?

That question doesn’t really have an easy answer. It’s somewhat akin to being asked to describe a typical Rorschach ink blot.

The truth is that melanomas can appear with a variety of looks. For instance, when several melanoma patients were asked to describe theirs, a wide assortment of answers were given. They can show up in different shapes, colors and textures. They may itch or not; secrete fluids or not. Some even match the color of the skin, while others look like a normal mole.

In fact, some moles that look awful can actually be harmless. And some that look harmless might turn out to be cancerous.

For example, below are some photographs to help illustrate. The one on the left seems to be little more than the result of an injury, or maybe nail fungus. The patient had it checked out and it was indeed melanoma. The photo on the right depicts an unsightly, even frightening-looking skin blemish. Yet, it was totally benign.

 

 

 

 

So How do I Know Which Skin Changes to Bring to My Doctor’s Attention?

This one’s easy. You don’t try and distinguish whether a skin issue is malignant or benign on your own. You would want to bring any new moles, blemishes or changes to existing moles to the attention of your dermatologist. Let them make the determination.

Out of Sight, but Keep in Mind…

There is no question that the vast majority of melanomas develop, and are easily spotted, on the skin. And most often by the patient first, before his or her doctor does. However, up to 10% of them are initially discovered in one or more of our other organs (skin is the body’s largest organ) or in a lymph node(s); with minimal to no outwardly visible mark or blemish.

There are dermatologists who theorize that these are due to melanomas that were not totally excised. Or “regression”; the belief that some melanoma cells made it into the bloodstream before the body’s natural defenses destroyed the cells that were on the skin. In other words, (non-medical jargon), the patient’s immune system closed the barn door after the horses had gotten out.

The photo below is one example of a melanoma with a “partial regression”

 

 

 

 

To visit our websites, please click:  skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma