Dermoscopy – accurate diagnostic for an efficient treatment

The dermoscopy represents a simple and non-invasive technique involving the examination of skin lesions by using a specialized instrument called dermatoscope.

The dermatoscope is based on the principle of skin light refraction optics and can be performed with polarized or non-polarized light depending on how shallow or deep the examined skin lesions are.

Thus, we manage to reveal the dermatoscopic features of actinic keratoses or seborrheic verrucas, sometimes difficult to differentiate from benign melanoma lesions, nevi (moles) or malign lesions (melanoma maligna).

The dermatologist places the instrument over the skin lesion and examines the morphological details that cannot be described by simply looking at it, thus facilitating the diagnosis.

dermatoscopia - skinmed

The utility of dermatoscopic examination consists in the possibility of identifying malignant skin lesions, such as melanoma or carcinoma, or of establishing the follow-up interval of such lesions, usually 3 months, for identifying any likely microscopic changes.

Further to dermatoscopic examination, the physician can decide on the benign nature of the lesion (keratoses, seborrheic verrucas, warts, angiomas, etc.) or on the malign nature, such as melanoma maligna or carcinoma, basal cell carcinoma, squamous carcinoma and in most cases, the action to be taken is the surgical excision with histopathological examination; sometimes, initially, the expert decides on performing a biopsy (shave, punch or excisional biopsy) with histopathological examination for a definite diagnostic prior to final surgical excision.
dermatoscopia - skinmed
The specialist can also decide on the dermatoscopic reevaluation every 3 months for the microscopic monitoring of the lesions; any notified changes shall require one of the above-described actions, pleading for the malignancy features, incipient malignant melanoma, and the lack of the same shall orient on the benignant nature of the lesion.

The dermoscopy is a highly valuable technique for the diagnostic of incipient malignant melanoma, malignant melanoma in situ, thus offering the prevention for this skin malignant pathology.

dermatoscopia - skinmed

FAQ 

Most of the times, nevi are harmless lesions; however, sometimes they can cause discomfort, be it esthetic, or functional (they cling to clothes, jewelries). There are also atypical nevi, or malignant lesions. Dermatoscopic examination is recommended for any new lesion or any lesion that changed its characteristics (color, size, shape, appearance of pruritus).

The most effective way for the patient to monitor the nevi is to use the ABCDE rule regularly. At the onset of any of the following signs, you should take a dermatoscopic exam at the specialist doctor!

 A-Asymmetry: lesion halves are not symmetrical

 B-Border-Margins: Check the margins, the contour of the lesion; in case of a suspect lesion, they may be irregular, may have the contour erased or there may be pigment (coloration) that extends to the surrounding skin

 C-Color: an irregular color, different shades within the same lesion (black, dark or light brown, gray, red, pink or blue)

 D-Diameter: In general, it is recommended to examine lesions larger than 6 mm, but also those that have increased in size

 E-Evolution: Any evolution (size, color, shape), but also the lesions that are different from the rest.

Most nevi are benign lesions that will not develop into risk-posing lesion or malignant lesions. Most patients have nevi that will remain unchanged throughout life, but if any of the above changes occurs, dermatological control and dermatoscopy are recommended to correctly differentiate harmless lesions from atypical, suspect, or skin malignant lesions (melanoma, basal cell carcinoma, spinocellular carcinoma).

Generally, any new lesion or a lesion with rapid growth, changes in shape or color should be examined dermatoscopically. Melanoma may appear as a nevus-like lesion, but it will often have more than one color on the surface (dark brown,  brown, black, white-gray, red, pink or blue), irregular margins, dimensions larger than other body lesions and an abnormal evolution (growth, shape changes). Melanoma may also appear as a fast growing nodule, colored in brown, black, or sometimes pink.

At SkinMed Clinic we have a team of dermatologists experienced in dermatoscopy, as well as a high-performance ATBM (Automated Total Body Mapping) system, which allows for a rapid and high-quality diagnosis of skin lesions.

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