Dermoscopy is itself a language full of terms that have specific meanings and even connotations, depending on any given lesion being examined. As in any language, its vocabulary is a work in progress based in consensus among its "expert" speakers who are striving to create a system to communicate dermoscopic findings based on observational data. In order for there to be mutual comprehension among users of this powerful technique, the language of dermoscopy must be spoken properly. This is not an easy task because there is a significant learning curve to master the technique as well as its terminology. It takes study, practice, and dedication.
Dermoscopy is the standard of care in many countries around the world and is becoming very popular in the United States. Dermatologists and other groups of physicians are realizing what a valuable tool it is. The goal of this book is to teach what we believe are the important general principles and specific points of dermoscopy and to allow for users to "self-assess" their knowledge and skills using the techniques taught here.
In an era of information overload, we designed the book to be short, sweet, and to the point. We want it to be an easy, enjoyable, and practical read. Important principles are often repeated which is a good way for them to be remembered.
We "keep it real" with 218 cases that any busy clinician may have the opportunity to see in general dermatology clinic on a daily basis. Great clinical and dermoscopic images with short histories are followed by five "true or false" statements. As in real life, then comes the decision making in check box form: what is the potential risk and what is the diagnosis? Finally, the disposition of the case; whether to effect no intervention, follow-up, or to make a histopathologic diagnosis? The concept of dermoscopic differential diagnosis is found throughout the book. In most cases, we do not get into the controversial issue of the best technique to make a histopathologic diagnosis. We leave that up to you.
Turn the page, and the answers to the statements are given in a format that separates our book from the others. The dermoscopic images are presented again with an extensive description of the criteria in the lesion. It is essential to evaluate as much as possible before making a diagnosis. There are many circles, boxes, arrows, and stars to point out the important features of each case. Our goal is to fully demonstrate the global features and local criteria of each lesion. This is another very important unique teaching point of our book.
Each case has a discussion of all of its salient features. Not in long drawn out paragraphs, but in outline form. We realize that your time is valuable and want to make the learning and recall process as easy as possible.
Series of cases are organized into groups. For example, there are lesions in which the major feature might be pigment network, dots and globules, regression, pink, blue or black color, or vascular structures. There are similar-looking clinical and/or dermoscopic images grouped together in specific body locations, such as brownish spots on an ear lobe or in the genital area. This simulates real-life encounters. One case often flows into the next and knowledge gained from the previous case is needed to solve the next case. Melanocytic, non-melanocytic, benign, malignant, or inflammatory pathology from head to toe with 80 melanomas and their most important simulators.
Each case ends with a series of dermoscopic and/or clinical pearls based on years of experience treating patients with atypically pigmented skin lesions and skin cancer. The patients' well-being trumps political correctness. The book is sprinkled with general principles and specific points that are controversial but strongly embedded in our core beliefs.
New features in the second edition include 69 new cases in chapters two through five, a chapter on trichoscopy and dermoscopy in general dermatology. There is a glossary with defintions of important specific points and general principles one might want to review at a glance. The latest information on fungal melanychia, pediatric melanoma, desmoplastic melanoma, nevi, and melanoma associated with decorative tatoos, Merkel cell carcinoma and invasive squamous cell carcinoma are also presented.
Being a cutting edge diagnostician must include the tissue-sparing and potentially life-saving technique called dermoscopy. Each of us has a profound responsibility for the well-being of every patient that walks through the door. Always regard each patient as someone's precious loved one as if they were your own!
Robert H. Johr
Boca Raton, Florida