Dermatoscopy

Dermatoscopy is a non-invasive method of examining the skin using an optical instrument with magnification and special lighting, called a dermatoscope. It allows the doctor to see structures and colours in the upper layers of the skin that are not visible to the naked eye.

The method is used mainly to assess moles and other pigmented lesions, but also non-pigmented growths and conditions of the scalp and nails. At Detalii Med in Baia Mare, dermatoscopy is carried out by Dr Alina Perța, senior consultant dermatologist, and Dr Greta Jurj, specialist dermatologist.

Dermatoscopy is recommended for people who:

• have a new mole that has appeared in adulthood;
• notice a mole that changes in shape, size or colour, or that itches, flakes or bleeds;
• have many moles or moles with an unusual appearance;
• have fair skin, have had repeated sunburn or have often used sunbeds;
• have a family history of melanoma or other skin cancers;
• have a skin growth they would like removed and that needs to be assessed first.

The examination can be done at any age and requires no special preparation.

Dermatoscopy helps the doctor to distinguish more accurately between benign lesions and those that need further investigation. It increases the accuracy of the clinical examination and can reduce both the number of unnecessary excisions of harmless moles and the risk of missing a suspicious lesion.

However, dermatoscopy does not give a definitive diagnosis in every case. When a lesion looks unclear or suspicious, the doctor recommends surgical removal and histopathological examination, the only method that can confirm the exact nature of a growth. Dermatoscopy does not treat lesions; it helps in making the right decision.

Before the examination, the doctor asks about the history of the moles, any changes the patient has noticed, sun exposure, past sunburn and any personal or family history of skin cancer. Older photographs of a lesion are also useful, if the patient has them.

On the day of the examination, the patient is advised not to apply make-up, self-tan or tinted cream to the areas to be examined, and not to wear nail polish if the nails are being assessed.

The doctor first examines the skin with the naked eye to get an overall picture, then looks at the lesions of interest with the dermatoscope. The instrument is placed on or close to the skin, and sometimes a thin layer of gel or liquid is applied for a clearer image. The examination involves no cuts or needles and leaves no marks.

Depending on the reason for the visit, one or several lesions, or the entire skin surface, may be examined. The doctor records the appearance of important lesions for later comparison. At the end, the doctor explains the findings and recommends one of the following:

• no special action, for lesions that look benign;
• review after an agreed interval, for lesions that need monitoring;
• removal of the lesion and histopathological examination, when its appearance is not reassuring.

Dermatoscopy requires no recovery. The patient can resume their activities immediately after the examination. If gel was used, it is easily wiped off the skin.

Between check-ups, it is helpful for the patient to examine their own skin about once a month, in good light, and to note any change. Sun protection, avoiding sunburn and giving up sunbeds are important recommendations for everyone with many moles.

Dermatoscopy is a safe examination, without radiation, and it does not usually have side effects. The point to bear in mind concerns the limits of the method: like any examination, it depends on the doctor's experience and on the characteristics of the lesion, and some lesions can be difficult to interpret.

For this reason, the result of a dermatoscopy does not replace further monitoring. If a mole changes in appearance after the examination, the patient should return to the doctor without waiting for the next scheduled check-up.

The result of the dermatoscopy is discussed on the spot, at the end of the consultation. The examination itself usually takes a few minutes for a single lesion and longer when the whole skin is examined.

If removal of a lesion is recommended, the histopathology result is usually available within a few days to a few weeks, depending on the laboratory. The review interval for monitored lesions is set individually, for example after a few months or once a year.

Dermatoscopy is a simple, non-invasive and very useful examination for assessing moles and other skin growths. It helps the dermatologist decide which lesions can simply be monitored and which should be removed and examined histopathologically. Any new mole, or one that changes, is worth checking early.