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.
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.