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Introduction to Dermatoscopy
Fundamental principle
Dermatoscopy should be considered as an integral part of the clinical dermatologic examination, and the interpretation of the dermatoscopic criteria is meaningful and helpful only within the clinical context of each particular patient. Knowledge of dermatoscopy is by no means a substitute for basic knowledge about pathogenesis, epidemiology, clinical morphology, and histopathologic features of skin tumors and other cutaneous diseases. On the contrary, dermatoscopy enriches and complements the cognitive framework of the physician on skin diseases.
1.1 Device
The dermatoscope is a handheld device with 10-fold magnifying optics, combined with a transilluminating light source. The expanded use of dermatoscopy among clinicians is based on the following important strengths: it is a fast and effective method applied with a small and inexpensive device. Therefore, the dermatoscope should be considered not as an imaging device but as a clinical tool that can be routinely used on all skin lesions by any physician dealing with skin disorders, acquiring a role similar to the stethoscope of physicians.
Digital dermatoscopic devices (videodermatoscopes) that allow much higher magnifications (up to ×200) also exist. Although these devices provide further insights into the morphology of skin lesions, they lack three important properties of the handheld dermatoscope: they require some time, space, and cost. Therefore, these devices are not convenient for use on all skin lesions during the daily routine. Instead, digital dermatoscopy has specific indications that are discussed in some chapters of this book. All the patterns, structures, features, or criteria described in this book can be seen with a handheld dermatoscope, unless otherwise clarified in the text.
1.2 Basic Parameters
The use of the dermatoscope reveals a morphological world of macroscopically invisible structures and criteria. The dermatologic patterns are composed of two basic parameters: colors and morphological structures.
1.2.1 Colors
Considering skin color as “neutral,” skin lesions are typically divided into two main categor...
