dermoskopia

Dermoscopy, also known as dermatoscopy, is a noninvasive diagnostic method used to examine skin lesions and cutaneous structures that are not visible to the naked eye. It involves the use of a dermatoscope, a handheld instrument that combines magnification with illumination, sometimes enhanced by immersion fluids and either polarized or non-polarized light.

During examination, the clinician places the dermatoscope on the lesion. In contact mode, the device touches the skin with a small interface fluid; non-contact mode uses polarized light to reduce reflections. Magnification is typically around 10x, enabling visualization of subsurface structures in the epidermis and superficial dermis.

Dermoscopy is widely used to assess pigmented skin lesions to distinguish melanomas and other skin cancers from benign nevi. It also aids the evaluation of nonpigmented lesions, inflammatory dermatoses, and nailfold capillaries (nail dermoscopy). It can guide biopsy decisions and monitoring.

Interpretation relies on pattern recognition and structured algorithms, evaluating features such as pigment network, globules, dots, streaks, colors, and structures like blue-white veil or milky-red areas. Training improves diagnostic accuracy and interobserver consistency.

Limitations include the need for training, potential for misinterpretation, and reduced accuracy in certain lesions, such as amelanotic melanomas or heavily keratinized lesions. Dermoscopy complements, but does not replace, histopathology and clinical judgment.

Overall, dermoscopy has become a standard tool in dermatology and primary care for skin cancer screening and lesion assessment.