Since the age of seven, Donna Randall has used bright colored yarn and a crochet hook to relax.

Since the age of seven, Donna Randall has used bright colored yarn and a crochet hook to relax.

“This takes a lot off of my mind,” Randall said.

From her home in Sedalia, Missouri she crochets hat after hat. Some are black and gold with trailing Mizzou scarves, while others are brown with lace trim. They all sit on foam mannequins, waiting to adorn the heads of cancer patients.

It’s a way to help others, she said, after her own health scare earlier this year. In 2016, Randall noticed a mole on the back of her shoulder was changing, and she asked her husband to take a look. He confirmed it had changed from black to brownish pink, and instead of being round, it had become elongated.

Randall’s primary care doctor at Katy Trail Community Health in Sedalia scheduled a telemedicine appointment with Kari Martin, MD, a dermatologist at University of Missouri Health Care.

From her clinic in Columbia, Missouri, Martin uses a computer and an iPad to see patients in every corner of the state, including Albany, Hannibal and Cape Girardeau. It’s one way to deal with a nationwide shortage of dermatology specialists, especially in rural areas.

“Dermatology is a very visual specialty,” Martin said. “Much of the time, I can make the diagnosis by seeing what the skin looks like, without needing to do further workup or a biopsy. It lends itself very well to telemedicine.”

As soon as Randall’s pictures came across the telemedicine software, Martin suspected melanoma, an aggressive form of skin cancer that can spread to other parts of the body. According to the American Cancer Society, melanoma accounts for only about 1 percent of skin cancers; however, it causes a majority of skin cancer deaths.

“I knew I needed to get it off as quickly as I could,” Martin said.

In cases like these, staff members usually work to schedule an excision within a few days. The weekend was approaching, though, and Martin decided Randall needed immediate attention. Randall jumped in the car and drove to Columbia that same morning. Just hours after her initial telemedicine appointment, Randall  her tumor was removed.

That quick action appears to have paid off, as Martin believes they were able to catch the melanoma before it spread.

“I’ve got an eight-inch scar, but I’ll wear it proudly as a survivor,” Randall said.

Martin tells her patients to remember the ABCDEs of melanoma. The acronym stands for:

•Asymmetry – Lesions that are not symmetric. One half may be a different color, size or shape than the other half.

•Border – Borders that are wavy or scalloped, not just circular.

•Color – Brown, light brown and medium brown are usually okay, but multiple colors —  including red, white, blue, or black — can be a warning sign.

•Diameter – Look for any new spot that is larger than the size of a pencil eraser, or six millimeters.

•Evolving – If a mole is changing, it’s time to see a doctor.

Women most frequently develop melanoma on the backs of their thighs, while men most often find it on their back. Martin said it’s important to check those hard-to-see areas, as well as skin that is frequently exposed to the sun, such as the face, forearms and upper chest.

Randall had never been in a tanning bed and doesn’t spend much time outdoors. She has a family history of skin cancer, though, and is now checking herself more often than before. “If you have moles, check them, check them, check them,” Randall said. “I keep watch on all of mine.”