A guide for dermatology nurses to assist in the early detection of skin cancer

Abstract

Early diagnosis of skin cancer, particularly melanoma, leads to improved morbidity and mortality. While nurses have been leaders in skin cancer awareness and education for decades, the nursing community can take a more active role in the fight against skin cancer. In order to assume this role, nurses must be familiar with diagnostic aids that help in the early recognition of skin cancer. Dermatology nurses facilitate care in the interdisciplinary team by focusing on patient centered outcomes. Nursing roles and responsibilities in the interdisciplinary team are vital to clinic pre-screening, improving public awareness, disseminating patient education, providing guidance regarding sun avoidance and protection, and providing education on the fundamentals of skin self-examinations and total body skin examinations. Nursing skin assessment requires knowledge of skin lesion morphology and biology, and pattern recognition.  As the sensitivity and specificity of naked eye examinations are suboptimal, dermoscopy provides a method for improving and streamlining skin lesion triage and assessment. In this review, we discuss a multi-prong approach to the diagnosis of melanoma, including  the ABCDE mnemonic, the “ugly duckling” concept, and some newer technologies (e.g., dermoscopy and total body photography) that aid in the early detection of skin cancers. Familiarity with these detection aids can provide nurses with a basic framework to aid in diagnosing skin cancer.