More Costly, Polarized Dermatoscope Results Compared to Nonpolarized Dermatoscope

Recent findings suggest a patient-administered a lower-cost, ambient-light, non-polarized dermatoscope performs as well as a higher-priced, illuminated polarized device, though price concerns may play a factor in choice.1

The investigators who led this research had set out to compare the results of this non-polarized dermatoscope and the more expensive, illuminated polarized dermatoscope when implemented by patients in teledermoscopy following early-stage melanoma treatment.

The data were authored by such investigators as Deonna M. Ackermann, MPH, from the University of Sydney's School of Public Health in Australia. Ackermann and colleagues' randomized study-within-a-trial was carried out within the larger MEL-SELF trial.2

Design and Notable Findings

Adults who had previously been treated for AJCC stage 0–II melanoma who and were taking part in the patient-led surveillance arm of the aforementioned study were included in this analysis. Ackerman et al's recruitment of such participants took place via specialist and GP-led skin cancer clinics located around the country of Australia between December 2021 - June 2024. Each of these subjects were followed for 12 months, and the investigative team's data analysis was done from February 2025 - August 2025.

Those involved in the study were randomized in a 1:1 ratio to be given either a polarized dermatoscope attachment (51.0%) or an ambient-light, non-polarized attachment (49.0%). The team made online training modules available but optional for participants. Those involved submitted images of clinician-flagged and self-identified lesions on an every-3-month basis, with a secure teledermatology system being implemented by Ackermann and coauthors.

Overall, the investigators' main outcome they evaluated was the proportion of subjects whose first images were of a sufficiently high quality for a teledermatologist to provide patients with a management recommendation. In their secondary assessments, Ackermann et al's aims included looking at the proportion of images deemed reportable, the percentage of those who received at least a single recommendation during the study, financial cost of devices and comparisons, and qualitative assessments of the devices' usability and picture quality.

There were 251 participants, all of whom had a mean age 56.0 years. 59% were women and 69.7% were provided with a management recommendation based on the images taken at baseline. This included 71.9% of subjects utilizing the polarized device and 67.5% of those utilizing the ambient-light option, a difference of 4.4% (95% CI, –7.0% to 15.8%). Ackermann and colleagues highlighted, by the 12-month mark, the proportion of participants who had been provided with at least 1 recommendation remained comparable between the 2 cohorts.

Specifically, the investigative team identified such a recommendation among 81.3% of the subjects with the polarized device and 76.4% of those with the ambient-light device. Such information reflected a difference of 4.3% (95% CI, –8.1% to 16.6%). In their per-image analysis, however, the team identified a more apparent distinction. They found a higher proportion of polarized images (95.0%) versus ambient-light images (91.1%) could be determined and then implemented to support a management recommendation. This finding showed a 3.9% difference (95% CI, 1.5% to 6.3%). In terms of self-detected lesions specifically, the gap was shown to have expanded to 6.8% (95% CI, 3.3% to 10.2%).

In their research, Ackermann et al found deledermatologists had suggested there were more favorable images with the polarized device, with improper lighting and blurriness being seen more often in the ambient-light cohort. Usability was rated similarly by patients across devices, although those using ambient-light device more frequently mentioned image quality problems. The polarized attachment cost substantially more ($324.16 as opposed to $35.40).

“Research on the feasibility of implementing different dermatoscope models, patient preferences for device ownership and use, and population-level impact assessments may help to determine the balance between cost, accessibility, and effectiveness in teledermoscopy implementation,” the investigative team concluded.1 “Larger studies stratified by melanoma risk may clarify whether baseline risk modifies device performance or clinical utility, supporting risk-stratified surveillance strategies.”

References

1. Ackermann DM, Medcalf E, Turner RM, et al. Mobile Dermatoscope Type in Patient-Performed Teledermoscopy: A Study Within A Trial. JAMA Dermatol. Published online December 03, 2025. doi:10.1001/jamadermatol.2025.4792.

2. Ackermann DM, Smit AK, Janda M, et al. Can patient-led surveillance detect subsequent new primary or recurrent melanomas and reduce the need for routinely scheduled follow-up? a protocol for the MEL-SELF randomised controlled trial. Trials. 2021;22(1):324. doi:10.1186/s13063-021-05231-7.