How Is Dermoscopy Performed?

Dermoscopy is useful in the evaluation of the skin surface.
Dermoscopy is useful in the evaluation of the skin surface.

Dermoscopy is useful in the evaluation of the skin surface. The doctor uses a handheld instrument, known as the dermatoscope. The physician covers the pigmented skin lesion with oil and alcohol to reduce the reflectivity of the skin and enhance the transparency of the outermost layer of the skin. By performing this, the physician gets a better visualization of the various layers of the skin that are not visible to the naked eyes, and it also suggests the location and distribution of melanin. The physician presses a dermatoscope against the lesion and the images taken by a dermatoscope may be photographed for storage. Post-procedure the physician may either decide to remove the skin lesions immediately or continue to monitor it.

What is dermoscopy?

Dermoscopy is a noninvasive technique that is primarily used for the examination of the skin using skin surface microscopy. Dermoscopy is mainly used to evaluate skin lesions to differentiate between cancerous and benign (noncancerous) skin lesions. It is also called ‘epiluminoscopy’ or ‘epiluminescence microscopy.’ It is primarily done for examining the pigmented (colored) skin lesions, although nonpigmented lesions may also be examined through this procedure.

Dermatoscope used for dermoscopy is a handheld device that consists of a high-quality lens and a lighting system for illumination and magnification purposes. It helps examine skin structures and patterns.

There are three types of dermatoscopes available:

  • Nonpolarized light, contact
  • Polarized light, contact
  • Polarized light, noncontact

Nonpolarized and polarized light help in the analysis of deeper structures and other minute details. Several convenient attachments may help video or still photography, which can even be done via a smartphone.

When is a dermoscopy indicated?

Dermoscopy is helpful in the evaluation of pigmented and non-pigmented skin lesions and to rule out the chances of skin cancers. A dermoscopic examination is useful in the following conditions:

  • Any new or changing lesion
  • Any lesions that cause discomforts in the patients, such as ulcerations
  • Skin lesions that appear to be abnormal compared to other lesions
  • Lesions that appear to be cancerous
  • Inflammatory and infectious disease of hair and nail, such as scabies
  • Finding a splinter in the skin
  • Abnormal blood vessels, such as atypical naevi or blue naevi
  • Evaluating hair loss

What are the benefits of dermoscopy?

The benefits of dermoscopy include:

  • Dermoscopy increases the sensitivity for the diagnosis of skin cancer
  • Dermoscopy improves the detection of benign skin lesions, thus avoiding unnecessary biopsies
  • It is useful in differentiating benign and malignant tumors
  • It allows the monitoring of lesions due to the deposition of melanin
  • It may be up to 35% more accurate than clinical diagnosis
  • It is noninvasive and painless
  • It provides clear and high-quality images of skin lesions
  • It is a low-cost technique
  • The results are immediate

What are the complications of dermoscopy?

Generally, dermoscopy has less to no complications because it is a noninvasive procedure (not involving the introduction of instruments inside the body). However, there may be small chances of cross infection between patients. This can occur especially with contact dermoscopy.


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