Why Dermoscopy?
Why Dermoscopy?
Why Dermoscopy?
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<strong>Dermoscopy</strong><br />
• Cheap<br />
• Fast for<br />
screening<br />
• Great quality<br />
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Digital <strong>Dermoscopy</strong><br />
• Expensive<br />
• Fast documentation<br />
• Sufficient quality<br />
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Instruments for Image Capture<br />
• Standard dermoscopy:<br />
– best quality and price for<br />
diagnosis and<br />
photography<br />
• (about € 1.000)<br />
• Digital dermoscopy:<br />
– faster and more reliable<br />
for follow-up<br />
• (about € 10.000)<br />
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Indications for <strong>Dermoscopy</strong><br />
Classic dermoscopy – pigmented and non-pigmented<br />
skin lesions<br />
Inflammatory dermoscopy – scabies &<br />
psoriasis/lichen planus<br />
Trichoscopy – classification of hair diseases<br />
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Psoriasis vulgaris or lichen planus<br />
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Lichen planus<br />
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Psoriasis vulgaris or lichen planus<br />
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Psoriasis vulgaris<br />
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dorsal<br />
ventral<br />
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Mite seen from the dorsal site<br />
Burrow filled with feces<br />
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<strong>Why</strong> <strong>Dermoscopy</strong>?<br />
<strong>Dermoscopy</strong> opens up a new dimension of clinical<br />
morphology<br />
<strong>Dermoscopy</strong> „forces“ physicians to dedicate more time<br />
and care for individuals with pigmented skin lesions<br />
<strong>Dermoscopy</strong> is more accurate than clinical examination<br />
based on four meta-analyses<br />
Digital dermoscopy allows easy storage & retrieval and<br />
opens the door for monitoring, teledermoscopy and<br />
automated diagnosis<br />
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4<br />
New Dimension of Clinical Morphology<br />
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First Prospective Study of the Recognition Process<br />
of Melanoma in Dermatological Practice<br />
Julie Gachon et colleagues<br />
Arch Dermatol 141: 434 – 438, 2005<br />
•Assessment of the overall pattern – cognitive process<br />
•‘Ugly duckling sign‘ – comparative process<br />
•Knowledge of recent change – interactive process<br />
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First Prospective Study of the Recognition Process<br />
of Melanoma in Dermatological Practice<br />
Julie Gachon et colleagues<br />
Arch Dermatol 141: 434 – 438, 2005<br />
•Assessment of the overall pattern – cognitive process<br />
•‘Ugly duckling sign‘ – comparative process<br />
•Knowledge of recent change – interactive process<br />
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Kittler H et al. Diagnostic accuracy of dermoscopy. Lancet Oncology 2002; 3: 159<br />
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Evolution of a 3 mm Spitz/Reed nevus in a 4-year-old boy over 3 years<br />
Argenziano et al. 2007 Arch Dermatol 143: 549 -- 551<br />
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Do we now<br />
monitor<br />
melanomas?<br />
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MoleMap Programme<br />
A comprehensive melanoma surveillance<br />
programme utilizing a tele-dermatology<br />
infrastructure.<br />
• Imaging systems in imaging clinics staffed by<br />
melanographers (nurses)<br />
• Uses total body photography combined with digital<br />
dermoscopic techniques and a comprehensive set<br />
of data collected during the procedure<br />
• Connects to a network of dermatologists highly<br />
experienced in the identification of melanoma –<br />
DERMOSCOPISTS<br />
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Global Comunity<br />
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http://www.skincancerclinic.blogspot.com/<br />
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June 09 Dermatology Research Centre 37
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‘The eye sees what<br />
the mind knows‘<br />
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