1. Home>
2. Specialties>
3. Dermatology>
4. Summary and Comment

Scope This Out

About 43% of dermatologists use dermoscopy on a daily basis to aid diagnosis of lesions — and to reassure patients.

For a more certain clinical diagnosis, some dermatologists use dermoscopy to magnify and examine the structure of skin lesions — for example, a pigmented neoplasm. The stratum corneum is rendered transparent by applying a liquid such as oil to the skin before magnifying it with a contact lens. Recently, investigators surveyed 105 dermatologists attending a seminar on dermoscopy to assess its usage.

Of the respondents, 60% had had dermoscopy training and 40% had not. Nevertheless, 43% of the dermatologists used dermoscopy at least once daily. For pigmented lesions, 90% of dermascope users employed a pattern-analysis algorithm. Sixty-one percent used dermoscopy because it reduced patient anxiety, even though 62% did not believe that it detected melanoma earlier than traditional measures. Thirty percent thought the process took too long, even though 82% said it took less than 1 minute to visualize one lesion.

Comment: I typically use dermoscopy many times each day. It amazes me that 40% of surveyed dermatologists have never used it. In my experience, the process reassures patients that the dermatologist possesses special diagnostic knowledge and technology, has "really looked" at the lesion, and takes the role of "mole police" seriously. Dermoscopy reassures me that a lesion is benign and sometimes identifies a clinically benign lesion as worrisome for cancer. It helps me differentiate basal cell carcinomas and other nonmelanoma skin cancers from other bumps. I would hate to be without a dermoscope.

Dermatologists tend to have a talent for pattern recognition, so it comes as no surprise that pattern-analysis algorithms trumped other methods. However, algorithms such as C.A.S.H. (color, architecture, symmetry, and homogeneity) quickly add valuable additional specificity.

— Mark V. Dahl, MD

Published in Journal Watch Dermatology October 16, 2009

Citation(s):

Noor O 2nd et al. A dermoscopy survey to assess who is using it and why it is or is not being used. Int J Dermatol 2009 Sep; 48:951.

• Medline abstract (Free)