Screening strategy
Whole body skin checks were conducted using a handheld dermatoscope, completed by an accredited skin cancer doctor focusing upon AK, NMSC and MSC using the chaos and clues algorithm16 and prediction without pigment, a decision algorithm for non-pigmented skin malignancy.17 These methods have been shown to significantly increase the diagnostic accuracy of detecting AK, NMSC and MSC when used by experienced clinicians. A digital dermatoscope with 10x magnification and LEDHQ illumination (Heine Delta 30, Heine, Optotechnic GhbH, Herrsching, Germany) was used to inspect any skin lesions as dermoscopy (epiluminescence microscopy) significantly increases the diagnostic accuracy of detecting PSC, NMSC and MSC when used by experienced clinicians.18,19