Dermoscopy in general dermatology: practical tips for the clinician

Abstract

In addition to its well-documented value in improving the diagnosis of skin tumours, dermoscopy is continually gaining appreciation in the field of general dermatology. Dermoscopy has been shown to facilitate the clinical recognition of several inflammatory and infectious diseases, as well as their discrimination from skin tumours. Moreover, recent data indicate that it might also be profitable in assessing the outcome and adverse effects of various treatments. Application of dermoscopy should follow the standard procedure of acquiring information from patient history and clinically evaluating the number, location and morphology of the lesion(s). Four parameters should be assessed when applying dermoscopy in the realm of inflammatory and infectious diseases: (i) morphological vascular patterns; (ii) arrangement of vascular structures; (iii) colours; and (iv) follicular abnormalities, while the presence of other specific features (clues) should also be evaluated. It must be underlined that dermoscopic findings should always be interpreted within the overall clinical context of the patient, integrated with information from the history and the macroscopic examination. With new evidence continuously being gathered, the dermatoscope gradually acquires a role similar to the stethoscope of general practitioners, becoming an irreplaceable clinical tool for dermatologists. In this article, we provide a succinct summary of existing data on dermoscopy in general dermatology. Practical tips are suggested, which can assist clinicians in profitably utilizing and applying the available knowledge in their everyday practice.

Dermoscopy guided dark-field multi-functional optical coherence tomography

“…Usage of dermoscopy has been recently extended to diagnose non-pigmented skin lesions [5][6][7] as well as to monitor the treatment response in various skin lesions [8][9][10]. However, dermoscopy can visualize only superficial features in the skin with inaccurate depth information due to lack of 3D resolution.…”

Trichoscopic Features of Linear Morphea on the Scalp

“…Dermoscopy has proven to be useful in the differential diagnosis of cicatricial alopecia and autoimmune diseases [2,3]. Dermatoscopic features of morphea have been reported in the literature.…”

Commentary on dermoscopy in general dermatology

“…Dermoscopy has also been found to be useful in the diagnosis of some facial dermatoses like rosacea, showing the presence of linear vessels arranged in a polygonal network ( Figure 3A) and discoid lupus erythematosus, characterized by erythema, perifollicular whitish halo, keratotic plugs, red dots, white scales (especially in early lesions), inhomogeneous pigmentation, and fine teleangiectasia (the latter 2 seen in latest stage) ( Figure 3B). As concerning sclero-atrophic dermatoses, morpheais dermoscopically characterized by whitish fibrotic beams and linear arborizing vessels ( Figure 4A), while in lichen sclerosus the dermoscopic hallmarks are follicular keratotic plugs and whitish patches ( Figure 4B) (1)(2)(3)(4)(5). Recently, the dermoscopic pattern of perforating dermatosis has also been described.…”

“…The expansion of dermoscopy has been facilitated by the development of handheld polarized dermatoscopes, which are portable, do not require skin contact and immersion fluid, therefore allowing a fast screening of cutaneous lesions. In recent times, several terms have been suggested to describe the use of dermoscopy in different fields, such as inflammoscopy for inflammatory skin diseases, entomodermoscopy for skin infestations, trichoscopy for hair disorders and onychoscopy for nail abnormalities (1,2). The application of dermoscopy for non-tumoral lesions should however follow the standard procedure, in fact its findings should be always interpreted considering the medical history and within the overall clinical context of the patient.…”