CRC DERMSCOP CLINIC PRAC PDF

Introduction

Giuseppe Micali and Francesco Lacarrubba

Dermatoscopy (D) - also called "dermoscopy" or "incident light microscopy" - is a non-invasive technique that allows a rapid and magnified in vivo observation of the skin with the visualization of morphologic features invisible to the naked eye. It may be performed with manual devices that do not require any computer "assistance" and allow magnifications up to X20, or with digital systems requiring a video camera equipped with optic fibers and lenses that ensure magnifications of up to X1000; in the latter instance the term videodermatoscopy (VD) is more usual. The images obtained are visualized on a monitor and stored on a personal computer, in order to process them and compare any possible changes over time. In many ways, VD represents the evolution of D. In this book the term "dermatoscopy" will be referred to the use of manual devices and "videodermatoscopy" to the use of digital systems operating at high magnifications.

Both D and VD are widely used in the differential diagnosis of pigmented skin lesions, usually through the technique called epiluminescence microscopy, which involves the application of a liquid (oil, alcohol, or water) to the skin to eliminate light reflection; recently, new systems utilizing polarized light may achieve similar results without the need for liquids. However, apart from their most common use for the differential diagnosis of pigmented skin lesions, it has been demonstrated that D/VD have expanded applications in dermatology. Alternative applications of D/VD include inflammatory diseases, parasitoses, hair and nails abnormalities, and a large variety of other dermatologic conditions as well as cosmetology. Importantly, for many of these disorders the use of high magnifications is needed for research as well as for clinical purpose. Depending on the skin disorder, D/VD may be useful for differential diagnosis, prognostic evaluation, and monitoring response to treatment. Moreover, the capability to capture digital images is perfectly suited to teledermatology - the "store-and-forward" technique that allows exchange of opinions between dermatologists - and might be useful when on-site D/VD services are not available.

The aim of this book is to advance knowledge of enhanced visualization/digital imaging using D or VD beyond the traditional indication of pigmented lesions of the skin. In particular, the book focuses on those conditions in which the techniques are more useful, describing the clinical and histopathological correlations associated with the procedure. The book has plenty of images that will be useful in the daily clinical practice of a dermatologist, who should thus be encouraged to utilize D/VD in the routine evaluation of skin diseases. The book will serve as an important yet relatively simple aid in daily office practice.