Dermoscopy or dermatoscopy refers to the examination of the skin using skin surface microscopy, and is also called ‘epiluminoscopy’ and ‘epiluminescent microscopy’. Derm(at)oscopy is mainly used to evaluate pigmented skin lesions. In experienced hands, it can make it easier to diagnose melanoma.
Dermoscopy requires a high quality magnifying lens and a powerful lighting system (a dermatoscope). This allows examination of skin structures and patterns. There are several different lightweight, battery-powered hand-held devices.
Dermatoscopic features of pigmented lesions
Using dermoscopy, the pigmentation of the lesion is evaluated in terms of colour(s) and structure.
Colours found in pigmented skin lesions include black, brown, red, blue, grey, yellow, and white.
Characteristics of the dermatoscopic structure of the skin lesions include:
Symmetry or asymmetry
Homogeny/uniformity (sameness) or heterogeny (structural differences across the lesion)
Distribution of pigment: brown lines, dots, clods, and structureless areas
Skin surface keratin: small white cysts, crypts, fissures
Vascular morphology and pattern: regular or irregular
Border of the lesion: fading, sharply cut off, or radial streaks
Presence of ulceration