DERMOSCOPY – EARLY SKIN CANCER DETECTION
Dermoscopy (epiluminescent microscopy or immersion diascopy) is a non-invasive, safe, painless in vivo diagnostic technique used to detect skin tumors. The technique allows for structures that are otherwise invisible to be seen. It uses an optical instrument called dermoscope together with the immersion oil or gel, which is used to illuminate the epidermis and make anatomical structures visible. Dermoscopy is usually used for early skin cancer detection (malignant melanoma as well as other malignant and benign skin tumors). However, this branch of dermatology helps detect other diseases, such as hair and nail disorders.
There are different types of dermoscopes available – from the simple, handheld dermoscope that utilizes ordinary or halogen lighting to the modern, digital dermoscopes that are mobile and operate with the help of computer software. Although dermoscopy first appeared in the mid 80s, it was not employed in Serbia until the beginning of the 21st century.
There are standardized dermoscopy criteria for different types of skin tumors, as well as various diagnostic models and methods. Each method is based on the analysis of specified dermoscopy criteria that appear on the skin and each has its own advantages and disadvantages.
Every dermoscopy criterion is in correlation with a particular histopathology report, which allows gaining insight into histological skin changes. Each skin change has its own specific criteria and their presence or absence determines the type of change (e.g. skin cancer or a mole).
Before the advent of dermoscopy, every skin change suspected of cancer (especially malignant melanoma) was surgically removed and sent to histopathological verification. When examining changes suspected of cancer, dermoscopy increases the accuracy of diagnosis by 30%. The number of tumors detected in the early stages of development increases, while the rate of unnecessary surgeries is decreased by 15%.
A large number of patients schedule a dermatologist’s appointment for a mole checkup, due to the injuries, visible changes to the mole, or the appearance of new moles. Most of the patients are afraid because they suspect they have malignant melanoma, which is one of the most dangerous tumors. Early detection and surgical removal of malignant melanoma are crucial for saving a patient’s life.
Every person that has a large number of moles (over 100), or asymmetrical, irregularly shaped and colored moles with a diameter of over 6mm, which grow bigger in size or bleed (ABCDE criteria), should undergo a dermoscopy examination. In the case of suspected skin cancer, mandatory surgical removal followed by a histopathology report is suggested. If the dermoscopy results do not reveal whether the patients suffer from skin cancer, the dermoscopy examination is scheduled to be taken again in one to three months.
Dermoscopy examination should be done each 6 to 12 months and are recommended to every person who experiences a multitude of skin changes or has a family member who was diagnosed with skin cancer. Early skin cancer detection is not the only advantage of dermoscopy; this diagnostic technique reduces the number of unnecessary surgeries, which results in fewer patients feeling afraid, anxious, and uncertain.