Dermoscopic examination is a simple, non-invasive technique that involves the analysis of skin lesions using a specialised instrument called a dermoscope.
Dermatoscopy is based on the principles of light refraction optics in the skin layers and can be performed with polarized or non-polarized light depending on the superficiality or depth of the dermatological lesions being followed.
This allows us to detect the dermoscopic characteristics of actinic keratoses or seborrheic warts, sometimes difficult to differentiate from benign melanocytic lesions, nevi (moles) or malignant (malignant melanoma).
The dermatologist places this instrument over the skin lesion and observes morphological details that cannot be described with the naked eye, thus facilitating the orientation towards a diagnosis.
The usefulness of dermoscopic examination lies in the possibility of identifying malignant skin lesions, such as melanoma or carcinomas, or it may be indicated to follow them up over time, usually every 3 months to identify microscopic changes that have occurred.
Following dermoscopic examination, the doctor may decide on the benignity of the lesion (keratoses, seborrheic warts, condylomata, angiomas, etc.).) or malignancy, such as malignant melanoma or carcinoids, basal cell, squamous cell and the indication is most often surgical excision with histapathological examination, sometimes, initially, it is decided to perform a biopsy examination (shave, punch or excisional biopsy) with histopathological examination to have a diagnosis of certainty prior to surgical excision with definitive intention.
Dermoscopy is a very valuable technique for the diagnosis of incipient malignant lesions, malignant melanoma in situ, and for the prevention of this skin malignancy.
Questions frequent
Most of the time, moles are harmless lesions, but sometimes they can create discomfort, either aesthetically or functionally (by catching on clothes, jewellery). There are also atypical nevi, or malignant lesions. It is recommended to examine dermatoscopically any newly appearing lesion, or one that has changed its characteristics (colour, size, shape, itching sensation).
The most effective way for patients to monitor their nevi is to regularly use the ABCDE rule. At the appearance of any of the following signs, you should have a dermatoscopic examination by your specialist!
A-Asymmetry: the lesion halves are not symmetrical
B-Border- Margins: check the edges, the outline of the lesion; in the case of a suspicious lesion, they may be irregular, have a blotchy outline or there may be pigment (staining) extending to the surrounding integument
C-Color: an irregular colour, different shades within the same lesion (black, dark or light brown, grey, red, pink or blue areas)
D-Diameter: it is generally recommended to examine lesions larger than 6 mm, but also lesions that have increased in size
E-Evolution: any development (size, colour, shape), but also lesions that are different from the rest of the lesions on the body.
