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CURRENT ISSUEGIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2000 August;135(4):445-57

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Actual trends in dermoscopy

Argenziano G., Soyer H. P. *

Università degli Studi Federico II - Napoli Clinica Dermatologica
* Università di Graz, Austria Clinica Dermatologica

Dermoscopy is a non-invasive diagnostic technique for the in vivo observation of pigmented skin lesions, allowing a better visualization of surface and subsurface structures. This diagnostic tool permits the recognition of morphologic structures not visible to the naked eye, thus opening a new dimension of clinical morphology by linking classical dermatology closer to cutaneous pathology. The recent history of dermoscopy starts in 1987 with the first publication of a new approach, called pattern analysis, for the diagnosis of pigmented skin lesions. In a recent systematic review dermoscopy has been reported to allow 10 to 27% higher sensitivity in diagnosing melanoma when compared to clinical diagnosis by the naked eye. However, it has been shown clearly that when using dermoscopy clinicians may improve their diagnostic performance only if trained formally. Subsequently, new diagnostic algorithms have been elaborated, the ABCD rule of dermatoscopy and the 7-point checklist, to name but two, with the aim to increase sensitivity in detecting cutaneous melanoma. A growing number of dermatologists are already equipped with digital systems, which can be handled easily requiring only some technical skills. The great advantage of these digital systems is the smooth storage and retrieval of images for follow-up examinations, which is particularly important for the management of patients with numerous Clark Nevi (also called dysplastic nevi). An even newer diagnostic approach, especially in communities where dermatologists are not available, is teledermoscopy that permits to send clinical as well as dermoscopic images of pigmented skin lesions for consultation using telematic networks. In our estimation, teledermoscopy may contribute significantly to reduce waiting time and workload in dermatologic clinics, spare the patients unnecessary distress, and ultimately save public money whilst providing a faster, reliable and more efficient service. The ultimate approach, however, is the automated diagnosis or more elegantly named computer-assisted or computer-aided diagnosis of a given pigmented skin lesion in order to obtain an unbiased and reproducible diagnosis. The future will show whether or not this fiction becomes reality.

language: Italian


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