SkinCancerNet Article
Dermoscope: A Device that Helps Detect Melanoma

Dermatologists diagnose skin cancer by first identifying a lesion that has the visual characteristics of skin cancer and then removing the lesion, or part of it, for microscopic examination (biopsy).

While a biopsy is still the most accurate diagnostic method for confirming or excluding a diagnosis of skin cancer, a handheld microscope-like device called a "dermoscope" can help dermatologists evaluate areas of concern. Used to evaluate melanomas and other pigmented skin lesions, the dermoscope magnifies a pigmented lesion and allows the dermatologist to see through the stratum corneum (bottom of the outermost layer of skin), which permits a detailed view of structures within the skin that are usually invisible to the unaided eye.

Studies have shown that dermatoscopy, also referred to as "surface microscopy" and "epiluminescence microscopy," can help determine:

  • Whether or not the pattern of pigmentation in a lesion indicates  cancer, which improves a dermatologistís accuracy in determining which skin lesions should be biopsied

  • If the pigmented section of a lesion is wider than the portion visible to the unaided eye, which helps ensure that the entire lesion and the right amount of unaffected skin is removed during treatment

  • If change is occurring in an atypical mole (when combined with baseline and follow-up photographs) that is not yet visible to the unaided eye, which aids in early detection

What a Dermatologist Sees Without and With a Dermoscope
To give you an idea of the visible differences that a dermoscope provides, the following photographs show the same lesion viewed without and then with a dermoscope.

WITHOUT a dermoscope, this lesion resembles seborrheic keratoses
(a non-cancerous growth that develops on the outer layer of skin).


 

WITH a dermoscope, branched streaks at the edge of the lesion and white areas within are visible, which suggests melanoma. A biopsy confirmed the lesion was melanoma.

 

WITHOUT a dermoscope, this lesion looks suspiciously like melanoma.




 

WITH a dermoscope, a pigmented network, branched streaks at the edge, and variegated color are clearly visible. Biopsy confirmed the lesion was nodular melanoma.

 

WITHOUT a dermoscope, this lesion looks suspiciously like melanoma.


 

WITH a dermoscope, the characteristics of superficial spreading melanoma are clearly visible. Biopsy confirmed the diagnosis.
 

(Photos used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

The enhanced view provided by a dermoscope also helps dermatologists to determine if additional diagnostic procedures may be necessary and to select an appropriate course of treatment. Of course, several other aspects, such as the patientís risk factors and medical history, also are considered.

References:
Langley RGB et al. Clinical characteristics. In: Balch CM et al (Eds). Cutaneous Melanoma, 3rd ed. St. Louis: Quality Medical Publishers, Inc.; 1998:82-101.

Langley RGB et al. Neoplasms: cutaneous melanoma. In: Freedberg IM et al (Eds). Fitzpatrickís Dermatology in General Medicine, 5th ed. New York: McGraw-Hill; 1999:1097-99.


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