Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ SYNONYMS ++ Dermatoscopy. Skin surface microscopy. Epiluminescence microscopy (ELM). Digital dermoscopy/digital ELM. Auflichtmikroscopie (German). Dermoscopia/dermatoscopia (Spanish). Dermoscopy and dermatoscopy are used interchangeably by experienced dermoscopists and in the literature. +++ DEFINITION ++ Dermoscopy is an in vivo, noninvasive technique in which oil or fluid (eg, mineral oil, gel, alcohol, water) is placed on the lesion. Fluid eliminates reflection of light from the surface of the skin, allowing visualization of color and structure in the epidermis, dermoepidermal junction, and papillary dermis. The color and structure visualized cannot be seen with the naked eye or with typical magnification that clinicians use. Polarizing light and digital instrumentation do not require fluid. When using polarized light dermoscopy: Light from a polarized light source penetrates the stratum corneum with less scatter. A second polarizer screens out scattered surface light, resulting in the physician seeing primarily light from the deeper structures. This removes the need for contact with the skin and the need for immersion fluids, resulting in faster examination times. There is noncontact and contact polarized dermoscopy. Gels can be used with contact polarized dermoscopy to enhance the appearance of vessels or eliminate the negative effects of dry skin. There is contact nonpolarized dermoscopy. Some criteria can be better visualized with polarized dermoscopy, such as small vessels and blue-white color. Some criteria can be better visualized with nonpolarized contact dermoscopy, such as milia-like cysts seen in seborrheic keratosis and melanocytic lesions. Crystalline structures (aka shiny white structures) can only be seen with polarized dermoscopy. All the criteria needed to make a dermoscopic diagnosis can be made using any form of the technique. +++ BENEFITS OF DERMOSCOPY ++ Helps to differentiate melanocytic from nonmelanocytic skin lesions. Helps to differentiate benign from malignant skin lesions. With dermoscopy, the sensitivity to diagnose melanoma is 85% and better compared with 65% to 80% when the technique is not used. Increases the diagnosis of early melanoma. Increases the diagnosis of amelanotic and hypomelanotic melanoma. Increases the diagnosis of melanoma incognito (clinically false-negative melanoma). Increases the diagnosis of inflammatory lesions (ie, lichen planus, psoriasis, seborrheic dermatitis, rosacea, discoid lupus erythematosus, granulomatous diseases). Increases the diagnosis of infestations (eg, scabies, head lice, crab lice). Increases the diagnosis of alopecia (eg. androgenic alopecia, alopecia areata) and hair shaft pathology (eg, monilethrix, trichorrhexis invaginata). Helps to avoid unnecessary surgery. Helps to plan surgery. Helps to work better with a pathologist (asymmetrical high-risk criteria, collision tumors, dermoscopic-pathologic correlation). Patient reassurance. Allows for follow-up of patients with a single nevus or multiple nevi digitally to find changes over time. +++ DERMOSCOPIC DIGITAL MONITORING ++ There are pigmented skin lesions that are not high-risk enough to warrant immediate histopathologic diagnosis, yet not so banal that there is no concern at all. There are melanomas that do not appear to be high-risk clinically or with dermoscopy. They are only diagnosed after monitoring for ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.