What is dermoscopy?

Dermoscopy is a technique for examining the appearance of the skin – ordinary skin as well as moles – to diagnose skin problems. It consists of using a handheld device, dermatoscopes, which combines strong magnification with good lighting to +/- a polarising filter to enable your dermatologist to get the best view possible of your skin problem.

Although dermoscopy can be helpful in all forms of skin diagnosis, it is particularly helpful for the diagnosis of skin cancer, particularly melanoma.

Dermoscopy and moles

Dermoscopy can be used to zoom in on a mole and to accurately see diagnostic details under the surface which are otherwise invisible to the naked eye. Moles recorded by dermoscopy can be compared over time so that even the slightest change that might indicate a pre-cancerous or cancerous change can be detected.

Dermoscopy combined with digital photography produces accurate mole mapping and suspect moles are then examined by Dr Bowling again using a dermatoscope. If worrying signs are confirmed, the next step is to have a biopsy to rule out or confirm cancer.

Dermoscopy in action

Dermoscopy

Polarised and non-polarised dermatoscopes

Three forms of dermatoscope are available:

  • Contact /oil immersion dermatoscopes: these are the older type of dermatoscope and require application of alcohol gel for the examination to be possible. This is a bit inconvenient (and messy) if all the moles on your body need to be mapped.
  • Non-contact / polarised light dermatoscopes: these are newer and are lighter and smaller and can be moved around the skin more easily as the polarising filter means that alcohol gel is not required for imaging.
  • Hybrid devices: these newer devices are able to combine both the above features.

Dr Bowling has all three models available and uses them in addition to computerized digital mapping of moles, when necessary. He is a recognised international expert in this technique and watches developments in the field very closely and has longstanding experience of using computer software to catalogue some forms of moles, such as numerous naevi in some patients.

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“Computerised mole mapping is an essential service for patients at high risk for melanoma. However, the software available alone, at the moment, is limited in what it can do – ultimately I rely on my extensive clinical experience and the power of the dermoscopes I have to view and assess individual moles and the mole pattern on individual patients. Software is excellent at supporting management, but it is too early to rely on it for diagnosis.”

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