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One comment on “[4 min watch] Dermoscopy in general dermatology | Part 2”

1. Hello Prof Giuseppe Argenziano, I would like to express my sincere gratitude for your high scientific career. You need no introduction, and I take the opportunity to share with you a simple summary of the benefit of using dermoscopy.

   Dermoscope:

   Introduction:
   It is a non-invasive diagnostic technique that allows for the observation of morphologic features that are not visible to the naked eye, thus forming a link between macroscopic clinical dermatology and microscopic dermatopathology. This “sub-macroscopic” observation of colors and structures enhances clinical assessment by providing new diagnostic criteria for the differentiation of melanoma from other benign and malignant neoplasms, both melanocytic and non-melanocytic.
   Technique of dermoscopy classically involves applying a liquid or gel to the skin surface and then inspecting the lesion using a hand-held, illuminated microscope (also called a dermatoscope), a stereomicroscope, a camera, or a digital imaging system. The mag- nification of these instruments ranges from 6× to 40× and even up to 100×.

   The widely used dermatoscope has a 10-fold magnification, sufficient for routine assessment of skin tumors. The fluid placed on the lesion eliminates surface reflection and renders the cornified layer translucent, thus allowing a better visualization of pigmented structures within the epidermis, the dermal–epidermal junction, and the superficial dermis. Moreover, the size and shape of vessels within the superficial vascular plexus are better visualized with this procedure.
   More recently, hand-held devices have been introduced that utilize polarized light which renders the epidermis translucent. With these latter devices, use of a liquid medium is no longer required in order to visualize sub-surface structures.
   Nowadays, the dermatoscope is increasingly being used by dermatologists as a stethoscope equivalent. This is because it not only facilitates the diagnosis of pigmented and non-pigmented skin tumors, but it also improves recognition of a growing number of non-pigmented skin coditions, For example, dermoscopy can facilitate the diagnosis of scabies due to the presence of the pathognomonic “jet with contrail” . Additional skin infections and infestations that may be differ entiated with increased confidence include pediculosis, tinea nigra, and molluscum contagiosum .For two of the more common inflammatory skin disorders – psoriasis and lichen planus – the use of dermoscopy allows for the visualization of specific sub-macroscopic features, including the “red dots” pattern in psoriasis and the “whitish striae” pattern in lichen planus .Scalp psoriasis and seborrheic dermatitis may also be differentiated via dermoscopy.
   The most notable scalp psoriasis features are red dots and globules, twisted red loops, and glomerular vessels, whereas seborrheic dermatitis is characterized by the presence of arborizing vessels and atypical red vessels, as well as featureless areas with no particular vascular pattern and no red dots or globules. One of the newest applications of this technique is trichoscopy, namely the dermoscopic observation of the scalp, which may prove helpful in the differential diagnosis of hair and scalp diseases.
   With regard to melanoma screening, the aim of dermoscopy is to maximize early detection while minimizing the unnecessary excision of benign skin tumors.

   Thank you so much for your patience in reading my humble introduction to the dreamoscope.

   All the best.
   Dr. Saad R. Abed
   Iraq.

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