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It is possible to suspect the presence of malignant melanoma by several signs: asymmetric, uneven and growing borders of a mole, an unusual color, a diameter of more than 6 mm. But in the early stages, it is very difficult to diagnose the disease by visual symptoms, since the initial melanoma may resemble the clinical signs of an atypical nevus. The introduction of dermatoscopy into medical practice opened up new possibilities for doctors to study pigment spots on the skin and made it possible to diagnose malignant melanoma at an early stage.
Why is dermatoscopy needed?
Dermoscopy is a non-invasive (without the use of surgical instruments) method for examining the color and microstructure of different skin layers (epidermis, dermo-epidermal junction, papillary dermis).
With its help, the accuracy of determining the early stage of melanoma has reached 90%. And this is very good news for all of us, because skin cancer is the most common cancer in the world.
They are much more common than lung, breast or prostate cancer, and over the past three decades, the number of cases of the disease has increased significantly.
The danger of melanoma is that you can get it regardless of age or skin color. There is a misconception that melanoma occurs only in tropical countries. They, as well as lovers of solariums, as well as people with fair skin, are in fact at an increased risk of developing the disease. But no one is immune from skin cancer, because one of the causes of the disease is ultraviolet, and all the inhabitants of the planet are more or less affected by it.
Everyone has moles and birthmarks, but sometimes they are reborn and become a real threat to human life. The prognosis of the development of the disease directly depends on the timeliness of the diagnosis. And for this it is necessary to undergo dermatoscopy – a painless examination using a dermatoscope.
The study of suspicious areas of the skin, as a rule, is carried out using light microscopy. In other words, the skin is translucent with a special device with a magnifying glass, which allows the doctor to examine changes not only on the outer surface of the epidermis, but also in deeper areas. Using a modern dermatoscope, you can see structural changes from 0,2 microns in size (for comparison: a speck of dust is about 1 micron).
What is a dermatoscope
Translated from Greek, the name of this device means “to examine the skin.” A dermatoscope is a dermatological device for examining different layers of the skin. It consists of a 10-20x magnifying glass, a transparent plate, a non-polarized light source and a liquid medium in the form of a gel layer. The dermatoscope is designed to examine moles, birthmarks, warts, papillomas and other formations on the skin. Nowadays, the device is used to determine malignant and benign skin degenerations without a biopsy. But the accuracy of diagnosis using dermatoscopy, as before, depends on the professionalism of the doctor who is to make the diagnosis.
Application of a dermatoscope
The traditional and most frequent use of a dermatoscope is the differential diagnosis of skin neoplasms. Meanwhile, the device can be used for other purposes. For example, to determine basalioma, cylindroma, angioma, squamous cell carcinoma, dermatofibroma, seborrheic keratosis and other neoplasms.
The same device is useful for diagnosing:
- different types of skin diseases not associated with oncology (eczema, psoriasis, atopic dermatitis, ichthyosis, lichen planus, scleroderma, lupus erythematosus);
- parasitic diseases (pediculosis, demodicosis, scabies);
- skin diseases of a viral nature (warts, warts, papillomas);
- condition of hair and nails.
The usefulness of a dermatoscope cannot be overestimated when it is necessary to determine the type of disease that has affected the skin under the hairline. For example, it facilitates the diagnosis of congenital non-tumor nevus, alopecia areata, androgenetic alopecia in women, Netherton’s syndrome.
Trichologists use this device to study the condition of hair follicles.
Dermoscopy can be very useful in the treatment of resectable forms of skin cancer. For example, with malignant lentigo, superficial basalioma, or Bowen’s disease, the contours of the damaged skin areas are uneven and very blurred. The dermatoscope magnifier helps to accurately determine the outlines of the cancerous surface, and then perform the operation on the required area.
Diagnosis and determination of how to treat warts also depends on the dermatoscope. The device allows the doctor to quickly and accurately determine the structure of the growth and differentiate it, to predict the risk of a new wart. And with the help of modern digital dermatoscopes, images of diagnosed areas can be obtained and stored, which is very useful for tracking trends in the skin.
Principle of operation
On the medical equipment market, there are different types of dermatoscopes from different manufacturers, but the principle of operation is similar for everyone. Dermatoscopes usually have a fixed head that contains one or more lenses to magnify the skin. There is a light source inside or around the head.
In modern models, this is most often a ring of LEDs that evenly illuminate the examined area. If this is a manual dermatoscope, then a handle with batteries inside always comes from the head.
To examine the pigmentation, the doctor applies the dermatoscope head to the skin area and looks into the lens from the opposite side (or examines the image on the monitor). In immersion dermatoscopes, there is always a liquid layer (oil or alcohol) between the lens and the skin. It prevents light scattering and glare, improves visibility and clarity of the image in the dermatoscope.
Types of dermatoscopes
Dermatoscopy is far from a new direction in medicine. True, in the old days, specialists used more primitive instruments to study the condition of the skin than they do today.
The “forefather” of the modern dermatoscope is an ordinary low power magnifying glass. In subsequent times, special devices resembling microscopes were developed on the basis of a magnifying glass. They gave a multiple increase in the condition of the layers of the skin. Today, dermatoscopes allow you to view existing formations at a 10x magnification or more. Modern models are equipped with sets of achromatic lenses and an LED lighting system.
Dermatoscopes can be classified according to different characteristics: by size, principle of operation, the need to use an immersion liquid.
A digital, or electronic, device is a modern model equipped with a screen that displays an image of the skin condition. Such devices give a very accurate picture, which is necessary for making a diagnosis.
With the invention of electronic dermatoscopes, it became possible to carry out digital diagnostics, photograph and record the examined skin areas in video files for further storage of information in the database and a more thorough study.
The material obtained by this diagnostic method can be analyzed using special programs. The computer, “evaluating” the presented image, automatically determines the nature of pathological changes in skin cells. The program issues its “conclusion” in the form of an indicator on a scale, indicating the level of danger (white, yellow, red).
According to the dimensions, dermatoscopes can be divided into two types: stationary and pocket. Equipment of the first type is impressive in size and more expensive, and is used mainly by specialized clinics. Manual type dermatoscopes are the devices that ordinary dermatologists and cosmetologists use in their practice.
According to the principle of functionality, dermatoscopes are immersion and polarization. The first option is the device used for traditional contact immersion dermatoscopy. Its peculiarity is the use of an immersion liquid in the course of diagnostics.
Polarizing devices use light sources with unidirectional electromagnetic waves and special filters. This eliminates the need to use an immersion liquid.
During diagnostics with the help of such a device, changes in the deeper layers of the skin are better visible. In addition, expert reviews indicate that such dermatoscopes provide a clearer image and, as a result, it is easier to make an accurate diagnosis.
A Brief Review of the Best Dermatoscopes
Heine mini 3000 is a small pocket type dermatoscope. It can work for 10 hours without changing batteries. The source of illumination is LEDs.
A feature of the Heine Delta 20 handheld device is that it can work both with and without immersion liquid (according to the principle of a polarizing dermatoscope). In addition, it is equipped with a contact board that allows you to connect to the camera. The lens has a 10x magnification.
German-made KaWePiccolightD pocket dermatoscope is lightweight, compact, and ergonomic. It is often used by dermatologists and cosmetologists for the early diagnosis of melanoma.
KaWe Eurolight D30 is distinguished by rather large contact glasses (5 mm in diameter), the lenses provide a 10x magnification. The illumination created by the halogen lamp can be adjusted. Another advantage of this device is a scale that allows you to determine the level of danger of pigmentation on the skin.
The Aramosg brand model is quite expensive, but also in demand on the market by dermatologists, cosmetologists and trichologists. In addition to traditional functions, the device can measure the level of skin moisture, has special lenses to determine the depth of wrinkles and a built-in ultraviolet lamp for disinfection. This is a stationary type dermatoscope with the ability to connect to a computer or screen. The backlight in the device is adjusted automatically.
The Ri-derma device is more affordable than the previous model in terms of cost, but also more limited in functionality. This is a handheld type dermatoscope with 10x magnification lenses and halogen illumination. Can run on batteries or rechargeable batteries.
Other popular dermatoscope options include the DermLite Carbon and the miniature DermLite DL1 that can be connected to an iPhone.
Examination with a dermatoscope is a painless, fast, effective and inexpensive way to distinguish ordinary birthmarks and moles from malignant neoplasms. The main thing is not to delay a visit to a dermatologist if there is suspicious pigmentation on the skin.