Dermatoscopy (also known by some as dermoscopy or epiluminescence microscopy) is the word used to describe the study and examination of the skin using a dermatoscope (also wrongly known as a dermoscope – see below).

The device can be very simple – not much more than a magnifying glass and an attached light bulb. Or it can be more complex. More sophisticated dermatoscopes have several magnifying lenses together in a tube with a polarized or non-polarized light source. The latest dermatoscopes have bright LED lights in a circle around the periphery of the dermatoscope magnifying lenses. Very often the more expensive dermatoscopes are connected to a digital camera so that images can be recorded and stored on a computer.

The use of a dermatoscope

Although there are a range of dermatoscopes available from several companies, they all work in the same basic way. Dermatoscopes usually have a fixed head containing one or more lenses to magnify the skin. Inside this head or around the edge of the lens aperture there is also a light source. In modern dermatoscopes there is usually a ring of LED lights to evenly light the area under inspection. Attached to the lens head is a handle that contains the batteries. If a dermatologist wants to examine an area of skin in detail, he/she applies the lens head of the dermatoscope onto the skin and looks through from the other side. The dermatologist can see a magnified area of skin lit by the light source in the dermatoscope head. Usually there is some kind of liquid between the magnifying lens and the skin – such as an alcohol solution or an oil solution. The use of a liquid reduces light scatter and glare and so helps to improve the visibility and clarity of the image viewed through the dermatoscope.

It takes three to six hours of use to understand the basics of a dermatoscope and to get some results. After initial training, continued practice is needed to further improve the ability to diagnose correctly and quickly using a dermatoscope. However, a dermatoscope can be an invaluable aid for almost all dermatologists. Potentially, this small equipment item can save lives and as such it is a valuable investment.

Dermatoscope applications

A dermatoscope is primarily used by dermatologists and physician specialists to help distinguish benign from malignant skin lesions. It is especially useful in the diagnosis of malignant melanoma. In this case, a dermatologist may need a close up view of the skin to distinguish a melanoma cancer from a benign mole. While melanoma diagnosis is the most common use for a dermatoscope, dermatoscopes may also be useful for many other diagnoses as well. Studies have been published that use dermatoscopes to evaluate capillaries in the skin and finger nail beds and to study patterns of hair follicles and their density. They have also been used to examine conditions including pityriasis rosea, spitz nevus, actinic keratosis, and even the consequences of drugs such as steroid atrophy evaluation.

It’s a dermatoscope not a dermoscope!

Although most dermatologists use the words “dermoscope” and “dermoscopy” when explaining the study of the skin using a magnifying instrument the correct words are actually “dermatoscope”, “dermatoscopy” and also “dermatoscopic.” Just to emphasise that – the study of the skin is called dermatology and not dermology! The form of words beginning with dermat- or dermato- combines the stem of the Greek word derma, meaning skin, or dermatos, of the skin. So dermatoscopy is the study of the skin with a magnifying device – a dermatoscope.