Numerous investigative modalities will be used, including telemedicine, to research skin disease. We will examine the respective roles of phenotypes, genotypes and environment in the aetiology of skin cancer to explore potential avenues for improved detection and diagnosis. Teledermatology, the remote analysis of skin lesions via provision of images to teledermatologists, is an exciting application which holds potential to provide peer support networks for clinicians and bring specialist knowledge into the wider community to help overcome the significant dermatologist shortage currently faced by the Australian health care system. We will investigate the feasibility of such a service for remotely located patients and physicians and also for acute skin conditions presenting to emergency departments. A key arm of our melanoma research seeks to develop novel detection methods to increase rates of early treatment and therefore reductions in mortality. The studies employ dermoscopy, a non-invasive skin examination technique, and reflectance confocal microscopy (RCM), a non-invasive imaging technique, for the early diagnosis of melanoma in high risk patients. We will explore the use of RCM for the cellular characterisation of melanoma precursors and link this to genetic evaluations of the correlation between phenotype and somatic genotypes on a lesional basis. In terms of keratinocyte cancers we will investigate the sequential progression of benign skin lesions to cancers in an effort to identify characteristics of morphological change which may help to better inform clinical decisions regarding management. We are also establishing a registry for patients with keratinocyte skin cancers and perineural invasion, the extension of a skin tumour in and around nerves, to gather data which to enable the development of a more effective treatment algorithm for the condition. The research is seeks to improve current practise with a view to eventual translation into policy.
