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Medical expert of the article
Dermatoscopy is a modern method that is used to diagnose various neoplasms on the skin without the need for surgical intervention. Thanks to him, the specialist is able to fix those changes that occur in the neoplasm during the early stages of degeneration. Thus, even before the onset of symptoms, a doctor can see the development of a malignant tumor.
Advantages and disadvantages
The main advantages of this method can be called:
- The possibility of examining moles and other neoplasms of any, even the smallest size.
- There is no need to damage the skin or the surface of the nevus.
- It is possible to diagnose melanoma at the initial stage.
- Dermatoscopy is a very fast procedure, it rarely takes more than half an hour.
- The specialist immediately gets the result.
Due to the fact that this method is completely safe and fast, it is quite difficult to find shortcomings in it. The only thing that when a melanoma is detected the doctor can be sure of the diagnosis only by 80%, so after that you still need to conduct a histological examination.
Indications for the procedure
Dermatoscopy is used for:
- Appearance of pigment nevi or moles.
- Conducting diagnostics of cancers on the skin.
- Conducting the diagnosis of keratoma or sunny keratosis.
- The appearance of hemangioma or angioma.
- Conducting a diagnosis of papillomas, warts.
In what situations can a specialist recommend dermatoscopy?
- If a new birthmark appears on the patient's body, which is characterized by rapid growth, or the old mole has begun to change (itch, flake off).
- If the patient accidentally injured the nevus.
- The patient decided to remove a convex birthmark on the face or other part of the body and wants to make sure that the tumor is benign.
- If a person has a lot of moles and constantly there are new nevuses.
- The patient's relatives had skin cancer / melanoma.
- The congenital nevus is in a place where it is constantly rubbed with clothing, and from time to time inflames.
Since dermatoscopy is a visual diagnostic method, the patient does not need to specially prepare for it. Neither anesthesia nor any serious preparation is used before this method. The only wish: do not apply any creams or other cosmetic products on the day of the examination to the place of the birthmark.
Dermatoscopy with melanoma
With melanoma, dermatoscopy is an inexpensive and effective method of diagnosis. It is non-invasive and a special tool called "dermatoscope" is used in the process of the doctor. On a new formation the liquid (an alcohol or an impulsion oil) is put, thanks to what those structures which are located in the top layer of a derma can be easily visualized.
The doctor evaluates the structural components and color shades of the nevus, which allows you to quickly differentiate the non-melanocytic or melanocytic nature of the mole. Thanks to this method, it is also possible to detect some structural phenomena of the neoplasm. So, for example, if the patient reveals areas without a structure, this means that the tumor (melanoma) regresses. When black small dots appear inside the structure, this indicates that the tumor is malignant.
With the help of dermatoscopy, complex surgical operations on pigmented formations can be avoided. This method makes it possible to increase the accuracy of the assessment of the diagnostic work several times. If you combine dermatoscopy and clinical diagnosis, you can increase the likelihood of timely detection of melanoma. In clinical diagnosis, specialists use the so-called "ABCD rule" (it stands for asymmetry, borders, hue and size). If the doctor sees that the tumor meets this rule, then, most likely, it is melanoma.
Recently, more and more doctors are paying attention to digital dermatoscopy, which helps to see a full picture of the nevus. This method is especially indispensable in the diagnosis of melanoma in the early stages of development.
Basal cell dermatoscopy
Basal cell carcinoma or basal cell carcinoma is a common type of skin cancer (76% of cases). The main difference of this tumor is its benign course. It is very important to identify basalomas at the initial stage, as it is at this time that it does not yet give metastases and is easily treatable.
Dermatoscopy is one of the most accurate methods for diagnosing a basal cell tumor. It differs in that it is not traumatic and helps to quickly carry out the necessary examination of the skin. Thanks to dermatoscopy, a doctor can accurately determine the basaloma, which, in clinical examination, is often confused with some other skin diseases: trichoepithelioma, psoriasis, dermatofibroma, dermatitis, syphilis, melanoma.
The main signs of a basal cell that the specialist discovers during the dermatoscopy are:
- Well-marked homogeneous zones, which are distinguished by a bright red or white color.
- The presence of small ulcers.
- The structure is dominated by capillaries of branching nature.
Dermatoscopy of nevus
When a new birthmark appears or the old nevus is quickly changed, it is very important to consult a specialist immediately. He will conduct dermatoscopy, which will help in time to detect skin cancer and conduct the necessary treatment. The main feature of this method in the diagnosis of nevus can be called the fact that it helps to see even the smallest changes. Thanks to dermatoscopy, the doctor conducts the most thorough and accurate analysis of the nevus. This is because the dermatoscope allows you to increase the growth up to ten times.
What does the doctor pay attention to when examining the patient with a dermatoscope? First of all, the size, symmetry, hue, border and structure of the nevus are examined. If he is a benign entity, then his species will always be symmetrical. With the appearance of even an unobtrusive asymmetry, we can talk about the development of skin cancer.
Dermatoscopy of the nevus is 80% accurate and does not require the patient special preparation for the procedure. If you have birthmarks that worry you, it is important to perform dermatoscopy at least once a year.
The device for carrying out the procedure
Dermatoscopy is performed with the help of a special apparatus of the dermatoscope, which allows tens of times to increase various neoplasms on the skin and fully consider its entire structure. As a rule, it is most often used during the diagnosis of melanoma. Modern dermatoscopes not only increase the birthmark, but also make digital photos of the tumor, which allows them to be taken out later on the screen and examined more thoroughly.
In addition, the digital dermatoscope shines through the upper layers of the epidermis and helps to see what happens to the neoplasm inside. The apparatus contains a set of achromatic lenses, which are characterized by a high degree of resolution.
What are digital dermatoscopes for?
- Diagnosis of any changes on the skin, especially those that lead to the development of moles.
- They help to identify a malignant neoplasm at an early stage.
- With their help you can evaluate various birthmarks.
- They allow you to evaluate the structure of the skin.
The dermatoscope is characterized by such functionality, thanks to which the specialist can correctly diagnose, evaluate the birthmark, symmetry or asymmetry of the lesion, check the size and shade, the edges of the mole and the possible presence of dots inside it.
To date, manufacturers produce a huge variety of dermatoscopes. The most popular among them are the following models:
- HeineMini 3000 - pocket dermatoscope, which runs on battery power (can work nine hours without recharging).
- HeineDelta 20 plus - has LED lighting, due to which the expert can more effectively study the surface of the tumor.
- KaWePiccolightD - suitable for early diagnosis of melanoma.
- AramoSG - dermatoscope can be connected to a computer.
Technique of the dermatoscopy
During the dermatoscopy, a dermatoscope examines the entire surface of the tumor on the skin and adjacent covers.
Before the procedure, the patient must lie down or sit down, as well as expose the place where the mole is located. In some cases, a little bit of gel or special oil should be applied to the skin. They will help reduce the reflection on the skin and increase the effectiveness of the method.
Digital and computer dermatoscopy
To date, digital dermatoscopy is the most popular and effective method of diagnosing melanoma and other malignant tumors of the skin. It especially helps to identify melanoma at an early stage of the disease, when other methods are powerless. Thanks to digital dermatoscopy, a specialist can immediately determine whether the formation is benign or not.
The process of examining the skin with a digital dermatoscope is somewhat like an ultrasound. The dermatoscope is pressed against the surface of the nevus, illuminating it so that it is possible to make images of the internal structure of the mole. This image can then be displayed on the computer screen, which makes it possible to better examine the neoplasm. In only a couple of minutes a specialist can consider all the changes that have occurred in the mole and make an accurate diagnosis.
ECD or epiluminescent computer dermatoscopy is the most modern method for diagnosing neoplasms on the skin. Its main difference is the use of polarized lighting, which better highlights the mole from the inside and gives the specialist an opportunity to look more closely at all its features. Thanks to ECD, it is possible to diagnose skin cancer with an accuracy of 95%.
The oncologist, having received the data of epiluminescent dermatoscopy, can determine whether it is necessary to remove the nevus, how important is the surgical intervention. In addition, all images are stored in the computer and if the patient again consults a doctor, he can match the old images with new ones.
Contraindications to the procedure
The main advantage of dermatoscopy, as the main method of diagnosing malignant neoplasms on the skin, is the fact that it has no contraindications. It can be done without fear even during pregnancy or feeding the baby with breast milk. The fact is that it is during this period that a very large number of new tumors can appear in women and it is important to check them as early as possible in order to avoid skin cancer.