Dermatoscopy of Neoplastic Skin Lesions: Recent Advances, Updates, and Revisions

Abstract

Opinion statementDermatoscopy (dermoscopy) improves the diagnosis of benign and malignant cutaneous neoplasms in comparison with examination with the unaided eye and should be used routinely for all pigmented and non-pigmented cutaneous neoplasms. It is especially useful for the early stage of melanoma when melanoma-specific criteria are invisible to the unaided eye. Preselection by the unaided eye is therefore not recommended. The increased availability of polarized dermatoscopes, and the extended use of dermatoscopy in non-pigmented lesions led to the discovery of new criteria, and we recommend that lesions should be examined with polarized and non-polarized dermatoscopy. The “chaos and clues algorithm” is a good starting point for beginners because it is easy to use, accurate, and it works for all types of pigmented lesions not only for those melanocytic. Physicians, who use dermatoscopy routinely, should be aware of new clues for acral melanomas, nail matrix melanomas, melanoma in situ, and nodular melanoma. Dermatoscopy should also be used to distinguish between different subtypes of basal cell carcinoma and to discriminate highly from poorly differentiated squamous cell carcinomas to optimize therapy and management of non-melanoma skin cancer. One of the most exciting areas of research is the use of dermatoscopic images for machine learning and automated diagnosis. Convolutional neural networks trained with dermatoscopic images are able to diagnose pigmented lesions with the same accuracy as human experts. We humans should not be afraid of this new and exciting development because it will most likely lead to a peaceful and fruitful coexistence of human experts and decision support systems.

Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non‐neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society

“…Besides its well‐established use in the assessment of skin neoplasms, dermoscopy is increasingly gaining appreciation as a supportive tool in the diagnosis of various non‐neoplastic dermatological diseases, including inflammatory, infiltrative and infectious dermatoses . Over the last few years, several papers have been published attempting to describe the dermoscopic criteria seen in numerous dermatoses, but there is poor consistency in the terminology among different studies.…”

Novel imaging techniques and their clinical applications in the field of dermatology

“…Azonban a regressziós jelenségek, mint a "peppering" PD-val vizsgálva kevésbé prominensek (7). Egyes szerzők szerint érdemes a NPD és PD technikával is megvizsgálni az elváltozásokat, amelyekre a korszerű, kombinált dermatoszkópok lehetőséget is adnak (8). A videodermatoszkópia elterjedésével az egyes léziók időbeli összehasonlítása, követése is lehetséges, továbbá nagyobb mértékű nagyítás érhető el, így további morfológiai jellemzők válnak láthatóvá, amely növelheti a diagnosztikus pontosságot (9).…”

“…Nemcsak a kórisme felállítására, hanem pl. basalioma (bazálsejtes karcinoma, BCC) esetén az altípus azonosítására, laphámcarcinoma (laphámrák, SCC) esetén a jól, illetve kevésbé differenciált tumorok elkülönítésére is alkalmazható (8). Hátránya, hogy a dermatoszkópos vizsgálat során észlelhető jellegzetességek, gyakran nem specifikusak, így eltérő eredetű elváltozások is mutathatnak hasonló képet, így a diagnosztikus pontosság nagyban függ a vizsgáló jártasságától.…”

Evaluation of dermoscopic criteria for seborrheic keratosis on non‐polarized versus polarized dermoscopy

“…Dermoscopy (dermatoscopy) is a non‐invasive diagnostic tool for examining benign and malignant skin lesions that are not visible to the naked eye . This technique increases the sensitivity of skin cancer detection and decreases the benign to malignant biopsy ratio.…”

“…This technique increases the sensitivity of skin cancer detection and decreases the benign to malignant biopsy ratio. Despite other non‐invasive diagnostic techniques, such as in vivo reflectance confocal microscopy and optical coherence tomography, having a better resolution, dermoscopy remains the most useful method because it is accurate, faster, easier to use, and widely available …”