Dermatoscopy in routine practice - 'chaos and clues'.

BACKGROUND Skin cancer is a major cause of mortality and morbidity in Australia, and primary care doctors can, and should, treat most cases. OBJECTIVE In this article we outline one method for the effective use of dermatoscopy in diagnosing melanoma and other skin malignancies in general practice. DISCUSSION The use of a dermatoscope in clinical practice has been shown to increase diagnostic accuracy and is considered the standard of care in assessing patients with pigmented skin lesions. Its use is also being increasingly applied to the diagnosis of nonpigmented skin lesions. Like any clinical tool, training is required for effective use. 'Chaos and clues' is a straightforward method of rapidly assessing suspicious pigmented skin lesions using a dermatoscope; its use can lead to improved diagnosis of melanoma and other skin malignancies.

[1]  S. Menzies.  Dermoscopy of pigmented basal cell carcinoma. , 2002, Clinics in dermatology.

[2]  B. Thiers,et al.  The CASH (color, architecture, symmetry, and homogeneity) algorithm for dermoscopy , 2008 .

[3]  L. Thomas,et al.  Dermoscopy provides useful information for the management of melanonychia striata , 2007, Dermatologic therapy.

[4]  B. Thiers,et al.  Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting , 2009 .

[5]  P. Aegerter,et al.  Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. , 2001, Archives of dermatology.

[6]  P. Schluter,et al.  Skin cancer surgery in Australia 2001–2005: the changing role of the general practitioner , 2007, The Medical journal of Australia.

[7]  H. Lorentzen,et al.  Dermoscopic color perspective. , 2006, Archives of dermatology.

[8]  T Burgdorf,et al.  The ABCD rule of dermatoscopy does not apply to small melanocytic skin lesions. , 2001, Archives of dermatology.

[9]  Harald Kittler,et al.  Diagnostic accuracy of dermatoscopy for melanocytic and nonmelanocytic pigmented lesions. , 2011, Journal of the American Academy of Dermatology.

[10]  J. Kreusch,et al.  How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part I. Melanocytic skin tumors. , 2010, Journal of the American Academy of Dermatology.

[11]  M. G. Fleming,et al.  Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. , 2003, Journal of the American Academy of Dermatology.

[12]  K Wolff,et al.  In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. , 1987, Journal of the American Academy of Dermatology.

[13]  C. Rosendahl,et al.  Dermatoscopy of unpigmented lesions of the skin: a new classification of vessel morphology based on pattern analysis , 2008 .

[14]  R P Braun,et al.  The significance of multiple blue‐grey dots (granularity) for the dermoscopic diagnosis of melanoma , 2007, The British journal of dermatology.

[15]  H. Kittler,et al.  Diagnostic accuracy of dermoscopy. , 2002, The Lancet. Oncology.

[16]  J. Kreusch,et al.  How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part II. Nonmelanocytic skin tumors. , 2010, Journal of the American Academy of Dermatology.

[17]  S. Menzies,et al.  Frequency and morphologic characteristics of invasive melanomas lacking specific surface microscopic features. , 1996, Archives of dermatology.

[18]  G. Argenziano,et al.  Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions. Comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis. , 1998, Archives of dermatology.

[19]  S. Menzies,et al.  Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy , 2000, The British journal of dermatology.

[20]  Harald Kittler,et al.  Dermatoscopy of pigmented Bowen's disease. , 2010, Journal of the American Academy of Dermatology.

[21]  H. Koga,et al.  Key points in dermoscopic differentiation between early acral melanoma and acral nevus , 2011, The Journal of dermatology.

[22]  Giuseppe Argenziano,et al.  Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis. , 2010, Journal of the American Academy of Dermatology.