What is dermoscopy?
Dermoscopy or dermatoscopy mentions to the examination of the skin by microscopy of the superficial of the skin and is also called “epiluminoscopy” and “epiluminescent microscopy”. Dermatoscopy is used primarily to evaluate pigmented skin lesions. Inexperienced hands, it can facilitate the diagnosis of melanoma.
Dermoscopy requires a high-quality magnifying lens and a powerful illumination system (a dermatoscopy). This enables the structures and patterns of the skin to be examined. There are several lightweights, battery-powered handheld devices. The practical accessories allow you to record video or take photos, even via smartphone.
Computer software can be used to archive dermoscopic images and allow diagnosis and expert report generation (mole mapping). Keen programs can aid in diagnosis by comparing the new image with stored cases with typical sorts of benign and malignant pigmented skin lesions.
Why dermoscopy is performed
During recent years, the use of dermoscopy has augmented in the context of general dermatological disorders including provocative dermatoses, pigmentary dermatoses, infectious dermatoses, and disorders of the hair, scalp, and nails. Some relations are used to describe specific indications: pigmentaroscopy for pigmented lesions, trichoscopy of the scalp and hair, nail onychoscopy, inflammoscopy for dermatoses and inflammatory lesions, as well as entomodermoscopy for skin plagues and infections. The role of dermoscopy in the diagnosis of disorders in general dermatology has been the subject of detailed discussion.
When it is done
Most skin lesions are benign. On average, a GP will diagnose a basal cell carcinoma every year, a squamous cell carcinoma every 1 to 2 years, and a melanoma every 3 to 5 years.2 Compare these frequencies to the large number of lesions that will be observed. benign. Therefore, the role of dermoscopy in primary care is to assist with the safe diagnosis of benign lesions. Any patient with a lesion that cannot be diagnosed as clearly benign or suspected of cancer should be referred or treated as appropriate.
Often times, a patient will present with a changing injury, a new injury, or an injury that they have never noticed before. An injury can be symptomatic, such as itching or scabbing. Many patients are anxious. No wonder patients seek medical advice for anything new, changing, or concerning. Dermoscopy helps make our evaluation much more complete and much more reassuring when we are diagnosing a benign lesion.
Dermoscopy is a very simple and painless procedure.
First, the doctor will apply an ultrasound gel or oil (such as mineral oil) to your skin. The gel or oil improves the clarity of the image that the dermatoscope can capture.
Once the gel/oil is applied, the doctor will gently press the dermatoscope on your skin. This does not hurt, but you will feel a little pressure from the dermatoscope. It is important that the dermatoscope is pressed against the skin to eliminate any air bubbles between the device and your skin that could interfere with the doctor’s field of vision.
The doctor then looks through the dermatoscope to obtain a magnified view of the skin lesion in question.
The images collected by the dermatoscope can be captured by video and/or still photography. These images can be saved for further evaluation. This allows for careful monitoring of suspicious skin lesions, especially those who are at high risk of developing skin cancer.
After doing that will be any complications
As a non-invasive technique, dermoscopy is essentially free of complications. The only problem is the minimal possibility of cross-infection between patients, especially with contact dermoscopy. Many tricks can avoid the possibility of cross-infection:
- Use of non-contact polarized dermoscopy.
- Disinfection of the lens (in case of contact dermoscopy) or the edge of the USB video dermatoscope with isopropyl alcohol afterwards investigative each patient.
- Use of disposable clear lens protective material, such as cling film or soft plastic caps on the device; the latter are now supplied as a complement to most high-quality dermatoscopes, for use in portable and USB video dermatoscopes.
Minor issues worth considering
- One should be aware of the artefacts of dermoscopy that can be misinterpreted. Common artefacts include vermilion powder, coloured powders, powder particles, hair dye, henna, hair fibre minoxidil crystals, hair styling gel, etc. in trichoscopy, powder particles, topical applications, especially sunscreen and makeup ingredients during dermoscopy of the face, and nail paint and varnish in onicoscopy. The area to be examined should be thoroughly cleaned with alcohol first to remove these artefacts.
- The colour difference between devices in the images: Different dermatoscopes tend to produce images with a slightly skewed colour balance. One must be aware of that and interpret the results accordingly.
- Differences in different Fitzpatrick skin types: It is now widely clear that many features that are easy to see in Fitzpatrick type I-II skin types are not visible or are obscured in darker skin types. Honeycombing on the scalp is considered suggestive of androgenetic alopecia (AGA) in Fitzpatrick skin phototypes I to III but is a normal finding on the scalp of people with darker skin types. The colours (black, brown, grey and blue) that are based on the histological level are not easy to observe or to interpret in dark skin. Brown pigmented structures are often seen on dermoscopy of various ethnic skin disorders due to the propensity for post-inflammatory hyperpigmentation and therefore require careful interpretation.
- Lack of ‘dermoscopic nomograms’: To master the interpretation of histopathology, one must be completely familiar with normal histology, taking into account the expected physiological variations due to a particular part of the human body, age and gender. For example, normal microscopic images of the buccal mucosa reveal abundant vessels, which should not be confused with a pathologic feature. There is an urgent need to have an image bank of such site-specific and skin-type-specific dermoscopic nomograms to minimize errors in the interpretation of dermoscopic structures.