Dermoscopy—The Ultimate Tool for Melanoma Diagnosis

“We are beginning to move away from clinicopathologic diagnosis into an era of clinicoimaging
diagnosis.” This vision became a fact, as the dermatoscope represents nowadays
the dermatologist stethoscope. This is not only because dermoscopy reveals a new and
fascinating morphologic dimension of pigmented and nonpigmented skin tumors, but also
because it improves the recognition of a growing number of skin symptoms in general
dermatology. Melanoma detection remains the most important indication of dermoscopy
and in melanoma screening the aim of dermoscopy is to maximize early detection while
minimizing the unnecessary excision of benign skin tumors. In the last few years, 3
meta-analyses and 2 randomized studies have definitely proven that dermoscopy allows
improving sensitivity for melanoma as compared to the naked eye examination alone. This
is the consequence of at least 3 issues: first, the presence of early dermoscopy signs that
are visible in melanoma much before the appearance of the classical clinical features;
second, an increased attitude of clinicians to check more closely clinically banal-looking
lesions; third, an improved attitude of clinicians to monitor their patients.
Semin Cutan Med Surg 28:142-148 © 2009 Elsevier Inc. All rights reserved.

“We are beginning to move away from clinicopathologic diagnosis into an era of clinicoimaging
diagnosis.” This vision became a fact, as the dermatoscope represents nowadays
the dermatologist stethoscope. This is not only because dermoscopy reveals a new and
fascinating morphologic dimension of pigmented and nonpigmented skin tumors, but also
because it improves the recognition of a growing number of skin symptoms in general
dermatology. Melanoma detection remains the most important indication of dermoscopy
and in melanoma screening the aim of dermoscopy is to maximize early detection while
minimizing the unnecessary excision of benign skin tumors. In the last few years, 3
meta-analyses and 2 randomized studies have definitely proven that dermoscopy allows
improving sensitivity for melanoma as compared to the naked eye examination alone. This
is the consequence of at least 3 issues: first, the presence of early dermoscopy signs that
are visible in melanoma much before the appearance of the classical clinical features;
second, an increased attitude of clinicians to check more closely clinically banal-looking
lesions; third, an improved attitude of clinicians to monitor their patients.
Semin Cutan Med Surg 28:142-148 © 2009 Elsevier Inc. All rights reserved.

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