Dermatoscopy is the examination of moles (including pigmented moles, i.e. moles) under magnification, using special equipment - a dermatoscope. The dermatoscope examination is painless and takes only a few minutes, and can detect melanoma, i.e. skin cancer, at an early stage of development. Check when a dermatoxopia should be performed and what the test looks like.

Dermatoscopy(aka dermoscopy) is aexamination of nevipigmented ( moles ) and non-pigmented nevi under magnification (about ten times), using special equipment - a dermatoscope.Dermatoscopic examinationis painless and takes only a few minutes, and can detect melanoma (skin cancer) at an early stage, when it can still be fully cured.

Dermatoscopy: indications

You should undergo a dermatoscopic examination every year, preferably in the autumn or winter period. People at increased risk of developing cutaneous melanoma should undergo the examination twice a year and each time in the event of a disturbing lesion. This group includes people who:

He should undergo a dermatoscope examination every year.

  • have a type I or II skin phenotype, which tan very little or not at all
  • have freckles or moles of different appearance (size, shape, color), especially large, irregularly shaped or unevenly colored
  • suffered sunburn in childhood or frequent exposure to strong sun in childhood or adolescence
  • have people in their family who developed skin cancer

Other indications for a dermatoscope examination are:

  • angiomas
  • cylinder changes
  • seborrheic keratosis
  • lesions of a dermatofibroma (histiocytoma) nature,
  • scabies
  • warts
  • watching the hair shaft or assessing the vascular bed of the nail fold in collagenoses

How to recognize melanoma?

Important

Changes that cause anxiety, i.e. when to see a doctor as soon as possible?

People who have noticed that their birthmarks have just appeared, are growing rapidly, are flaky, itchy, bleed, have a dermatoscope, should report to a dermatologist as soon as possible.irregular edges, uneven color and change quickly. Other symptoms that should be alarming include oozing moles, redness around the mole, swelling, and pain.

Dermatoscopy - what does the examination look like?

The first step in the diagnosis of melanomas is to collect a careful history. The doctor asks the patient if any moles cause him concern and why (e.g. the lesion has increased rapidly, changed color, etc.) and whether the patient is at increased risk of developing skin melanomas (e.g. sunburn, tanning beds, melanomas). in the family).

The purpose of dermoscopy is to distinguish malignant from benign lesions, determining whether or not the lesion being assessed requires surgical resection.

Then the doctor looks at the moles with a special device - a dermatoscope - resembling a flashlight with a magnifying glass. It has several or several times magnification, and the built-in side lighting (illuminating the viewed surface) allows for a "three-dimensional image" of the skin (it reveals the deeper structures of the observed lesion).

Each patient should be examined from head to toe. Such a careful assessment of the skin helps to avoid overlooking changes that may be early melanoma or basal cell carcinoma. The doctor should pay special attention to the armpit, inguinal area, interdigital spaces, hands, feet, nails, intimate areas and the scalp (the so-called areas that are difficult to access for self-examination).

How does a dermatoscope work? Explains the dermatologist Łukasz Preibisz

Source: x-news.pl/Dzień Dobry TVN

Photo- and videodermatoscopy

Examination of skin birthmarks can also be performed with the use of modern digital dermatoscopes: photo- or video-dermatoscope. The photodermatoscope is a combination of a dermatoscope with a camera and a special computer with a monitor. The photo of the birthmark is sent to a computer, thanks to which the doctor has the possibility to carefully view the skin lesion in high resolution on a large screen. The photos are saved on the hard drive, which in the case of subsequent visits allows you to accurately trace the evolution of the change.

In turn, a video dermatoscope (digital dermatoscope) is a device consisting of a head equipped with a camera and a special computer with a monitor. During the examination, the doctor places a head on the assessed area and the camera transmits the electronic image of the skin lesion to the computer. The videodermoscope software then analyzes the lesion and also calculates an average cancer probability score. In a word - the program tells you whether we are dealing witha typical pigmentary nevus, or already skin melanoma. Thanks to the archiving function, it is possible to assess whether the pigmented mark has changed in the period between examinations.

Dermatoscopy - interpretation of test results

Multiple schemas have been developed for dermoscopic evaluation of skin pigmentation changes - ABCD (E), Glasgow 7-point scale, three-point checklist, and pattern analysis .¹

The most commonly used criteria are ABCD (E), which include:

  • A - asymmetry of the lesion, e.g. a pigmented mark "pouring out" on one side or showing asymmetrical distribution with respect to each axis
  • B - uneven, irregular edge, jagged, with thickenings, indentations or protrusions
  • C - uneven color of the mark from light brown to black and steel with uneven distribution of the dye
  • D - diameter over 6 mm
  • E - evolution over time, i.e. progressive changes taking place in the birthmark while it is present on our skin, visible dynamics of changes

The Glasgow 7-point scale has the following features:

1 - lesion enlargement2 - shape change3 - color change4 - presence of inflammation5 - presence of oozing, bleeding from the lesion or visible scab6 - sensory disturbance (e.g. itching and hyperalgesia) 7 - dimension above 7 mm

These scales are currently used mainly for educational purposes, as they allow the identification of a significant proportion of advanced melanomas. However, none of them can be used as a diagnostic (screening) tool in practice .³

The essence of the three-point scale is the assessment of three parameters of the pigmented lesion:

1 - asymmetry of colors and structures2 - atypical dye mesh3 - presence of steel-blue structures

Finding 2 out of 3 features increases the probability of recognizing a lesion as malignant

Pattern analysis - which is the most accurate pattern - allows to distinguish between melanocytic and non-melanocytic changes by analyzing the pattern of the change in a general (global) aspect, and then defining the nature of the lesion using local features compared to the dermoscopy alphabet. In global diagnostics, 10 basic patterns of changes are distinguished: reticular pattern, globular pattern, cobblestone pattern, homogeneous pattern, star burst pattern, parallel pattern, multi-component pattern, sinus pattern, non-specific pattern, nodular pattern. On the other hand, in local diagnostics, the structural elements of the pigmented lesion are assessed, such as: mesh, pseudo-mesh, dots and clustered bodies, branch streaks, pseudopodia, veil symptom, discoloration, discoloration, regression symptom, vascular structures,red-violet bays .¹

Dermatologist Anita Tarajkowska-Olejnik - we report not only changes in the type of birthmarks

Source: x-news.pl/Dzień Dobry TVN

Important

The sensitivity of dermatoscopy is estimated at 95%, but it should not be the only diagnostic method in the diagnosis of melanoma, but a complementary test for a clinical trial, as only the combination of both methods significantly increases the detection of early "thin" melanoma. Dermatoscopy can lead to an excessive number of both false positive and false negative diagnoses. Dermoscopically benign lesions may be classified for surgical removal as "suspicious" or malignant and vice versa .²

Bibliography:

1. Woźniak W., Wawrzynkiewicz M., Wojas-Pelc A., The role of dermoscopy in the assessment of acral melanocytic changes, "Przegląd Dermatologiczny" 2012, No. 992. Alekseenko A., Duliban M., Lazar K., Dermoscopy in practice, "Medycyna Rodzinna "2009, No. 3

3. Skin melanoma. Recommendations for diagnostic and therapeutic management in malignant neoplasms - 2013, under edited by Rutkowski P., Wysocki P

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Research