dermatoscopes - epiluminescence imaging dermoscopy

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What is skin imaging

What is a dermatoscope
Advantages of a dermatoscope

Dermatoscope history

Dermatoscope uses

Dermatoscope prices

Dermatoscope application techniques

Dermatoscope lighting techniques
Dermatoscopic skin structures
ABCDE melanoma algorithm
Melanoma cancer evaluation
Hair and scalp evaluation
Dermatoscopy in dark skin
Dermatoscopes as disease vectors

Dermatoscope books

dermatoscope prices

In its most basic configuration, a dermatoscope can cost as little as $300 US. More complex dermatoscopes, particularly those with digital imaging capabilities can cost several thousand dollars. Which one is right will depend on the dermatologist and the nature of the dermatology clinic.

For a dermatology clinic that caters to the general public on a small scale, relatively cheap handheld dermatoscope devices may fulfill all of the dermatologist’s requirements. For larger clinics, particularly those involved in research and clinical drug trials, a digital dermatoscope may provide both diagnostic capabilities and an excellent way to record skin lesions for patient notes, research reports, or clinical trial reports.

The price for a dermatoscope inevitably relates to the functionality of the dermatoscope make and model. The simplest, like a Heine Delta 10, provides the bare basics, but a more expensive model may be easier to use, give a better image, and enable more accurate diagnosis.

Dermatoscope requirements

hand held dermatoscopeIn order to correctly evaluate skin lesions using a hand-held dermoscope, it is essential to have adequate magnification and illumination to allow the differential structures to be clearly seen. At a minimum a 10x optical magnification is required. Higher magnifications are also available either by changing the lens cluster or, with digital image taking dermatoscopes, by using an optical zoom feature.

The optics in a dermoscope are worth considering. Like cameras, the quality of lenses can be variable. Lenses without blemishes are important to minimize light scatter and improve image quality. While cheap dermatoscope lenses can be obtained from the far east, they may not give a superior result. German dermatoscopes are well known for their good quality lenses made from hardened glass or composites. Indeed, germany tends to lead the world in lens quality in cameras and microscopes - albeit closely followed by Japan.

Lighting is very important for effective use of a dermatoscope. In the newer dermoscopes (for example the Heine Delta 20, Dermogenius and Dermlite Foto) the light sources are much improved compared to older models. Now 6 or even 24 LEDs are employed to light the field of view. The use of several LEDs is a significant advance over the use of a single halogen light bulb giving much better and more even lighting of the skin. This distinctly improves the image quality with regard to color and visible differential structures compared to older dermatoscopes (for example the Heine Delta 10). As such, a newer model with an LED light source is a good investment, but somewhat more expensive than the older, more basic models. Expect to pay $500-$1,000 for a handheld dermatoscope with good LED lighting built in.

Digital dermatoscopes

Using a digital zoom (found on some modified camera based dermatoscopes) is not suitable as this reduces the resolution (number of pixels per unit area of the image) of the image on the computer screen. A digital zoom is actually just some software inside the camera that takes a smaller proportion of the original digital image and blows it up to the required images size. So an image taken with a high digital zoom magnification actually reduces the clarity of an image and fails to provide any additional detail in the image. In contrast, an optical zoom (found on better quality digital camera based dermatoscopes and specifically designed digital dermatoscopes) uses lenses instead of software to take a higher resolution image over a smaller area of skin. An optical zoom ensures that the number of pixels per unit area of an image stays the same.

digital camera dermatoscopeIf the dermatoscope is entirely digital and a computer must be used to view the image (you cannot use your own eyes to view the image directly through the dermatoscope lens), then the resolution of the light sensing chip becomes more important. Basically, the higher the number of pixels the better the image quality. However, the more pixels involved, the bigger the images files produced and so the more powerful the computer required to display the images. Correspondingly, digital dermatoscopes with good imaging capabilities can be a very expensive option. Some dedicated digital dermatoscopes and their associated computer hardware and software and easily amount to over $20,000.

If you don't need to take and store digital images, a simple handheld dermatoscope is probably enough for your needs. If you want to give your patients more feedback, a digital dermatoscope attached to a computer and printer can give them something to take home - a surprisingly effective method of informing patients as to their skin conditions. But of course the cost is correspondingly more expensive. A cheaper option than a dedicated digital dermatoscope (like the Fotofinder range) is a modified digital camera set up. Some (Like the Trichoscan system) are essentially a good quality digital camera to which a hardened glass close up lens extension and LED ring light are attached with a screw thread that is put on some digital cameras. The cost then is the cost of the digital camera ($200-400) plus the close up lens extension ($200-$400) and an LED ring light ($200). Buying a complete package including image software runs to around $1,000.

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