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22-06-2013 | Skin cancers | Book chapter | Article

13. Dermoscopy

Authors: Susana Puig, MD, PhD, Joseph Malvehy, MD

Publisher: Springer New York

Abstract

Dermoscopy (also known as dermatoscopy and epiluminescence microscopy) is a noninvasive, in vivo technique that has demonstrated to be an important aid in the early recognition of malignant melanoma and other skin tumors. Its use increases diagnostic accuracy of malignant melanoma between 5 and 30 % over clinical visual inspection depending on the type of skin lesion and the experience of the physician. At the present days, the use of dermoscopy in the evaluation of any skin tumor has a maximum level of evidence and included as standard of care in clinical guidelines of melanoma.

Atypical Mole Syndrome (AMS)

is the most important phenotypic risk factor for developing cutaneous melanoma. It is otherwise known as heritable melanoma syndrome; it refers to a group of patients who appear to inherit a tendency to develop dysplastic naevi. This inheritance appears to follow an autosomal dominant pattern

Cross-polarization filter

in dermoscopy, is the system by which skin can be visualized through the stratum corneum without the need of applying immersion liquids. The scattered light from the deep tissue structures has altered its polarization and can pass through the filter for imaging. Cross-polarization cancels out the light that is being reflected by the skin surface, thus allowing a deep, glare-free view into the skin–without immersion fluids

Cyclin-dependent Kinase Inhibitor 2A (CDKN2A)

Acts as a tumor suppressor. In MM, disease susceptibility is associated with variations affecting this gene. In familial atypical multiple mole melanoma-pancreatic carcinoma syndrome (FAMMMPC) mutation carriers within families may develop either or both types of cancer. In melanoma-astrocytoma syndrome (MASTS), disease is caused by mutations affecting this gene

DFU

Digital dermatoscopy follow-up

GPs

General practitioners

Non-polarized light dermoscopy

requires oil or gel for contact. Gives brighter images. It allows a better visualization of milialike cysts and comedolike (more helpful for identification of seborrheic keratosis) and peppering, lighter colors, and blue-white areas are also more evident, facilitating recognition of regression areas. It is a complement to

Polarized light dermoscopy

requires no contact. With PD, melanin appeared darker and blue nevi had more shades of blue; vessels and red areas are better visualized as well as shiny-white streaks

TBP

Total body photography

Tyndall effect

also known as Tyndall scattering, is light scattering by particles in a colloid or suspension. The preferential absorption of long light wavelengths by melanin and the scattering of shorter wavelengths, representing the blue end of the spectrum, by collagen bundles gives a blue color to those lesions where melanin is localized within the reticular dermis

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Medicine Matters Oncology

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