“Tape dermatoscopy”: constructing a low-cost dermatoscope using a mobile phone, immersion fluid and transparent adhesive tape

Importance: Medical professionals and indeed the general public have an increasing interest in the acquisition of dermatoscopic images of suspect or ambiguous skin lesions. To this end, good dermatoscopic image quality and low costs are important considerations. Observations: Images of seven lesions (seborrheic keratosis, melanoma in-situ, blue and dermal nevus, basal cell carcinoma and two squamous cell carcinomas) were taken. A novel technique of “tape dermatoscopy” involved: Using immersion fluid (i.e., water, olive oil, disinfectant spray) placed on the flat or slightly elevated lesion; Covering the lesion with transparent adhesive tape with lateral tension; Using ambient indoor or outdoor lighting for illumination (rather than flash photography); Positioning a photographic device at an angle of approximately 45° from the side of the lesion to avoid light reflection; Recording a focused image with a mobile phone or digital camera at a distance of approximately 25–30 cm from the lesion; and Enlarging the image on the screen of the device. Essential dermatoscopic features enabling a correct diagnosis were visible in 6 of the 7 lesions. ‘Tape dermatoscopy” images of the lesions were compared to standard dermatoscopy (using a Fotofinder handyscope® in combination with a mobile phone). The latter confirmed the dermatoscopic features in six of seven lesions. Conclusions and Relevance: “Tape dermatoscopy” images can be recorded by medical personnel and even the general public without a dermatoscope. However, the limitations of this method are that images may be unfocused, exophytic tumors may be difficult to assess, excess pressure on tumoral blood vessels may lead to compression artefact, dermatoscopic features that are only visible under polarized light are unable to be detected (particularly “crystalline” or “chrysalis” structures) and tumors in certain anatomic locations may be difficult to assess (e.g., edges of nose, ears [demonstrated in one case], nails). Comparative prospective studies are necessary in order to test reproducibility of these preliminary findings, to establish special indications for the technique, and to develop guidelines for its effective use.

[1]  D. Moreno-Ramírez,et al.  Effect of teledermatology on the prognosis of patients with cutaneous melanoma. , 2012, Archives of dermatology.

[2]  G. Fabbrocini,et al.  Telediagnosis and face‐to‐face diagnosis reliability for melanocytic and non‐melanocytic ‘pink’ lesions , 2007, Journal of the European Academy of Dermatology and Venereology : JEADV.

[3]  G. Reiber,et al.  Teledermatology in the diagnosis of melanoma , 2014, Journal of telemedicine and telecare.

[4]  A. Oakley,et al.  Better, sooner, more convenient: A successful teledermoscopy service , 2012, The Australasian journal of dermatology.

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

[6]  Giovanni Pellacani,et al.  A clinico-dermoscopic approach for skin cancer screening: recommendations involving a survey of the International Dermoscopy Society. , 2013, Dermatologic clinics.

[7]  Masaru Tanaka,et al.  Self-assembly of a simple low-cost dermoscope for examination of skin lesions , 2013, Dermatology practical & conceptual.

[8]  Riccardo Bono,et al.  Dermoscopic evaluation of amelanotic and hypomelanotic melanoma. , 2008, Archives of dermatology.

[9]  John Paoli,et al.  Smartphone teledermoscopy referrals: a novel process for improved triage of skin cancer patients. , 2015, Acta dermato-venereologica.

[10]  A. Marghoob,et al.  Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study , 2008, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[11]  S. Menzies,et al.  Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta‐analysis of studies performed in a clinical setting , 2008, The British journal of dermatology.

[12]  M Rademaker,et al.  Successful triage of patients referred to a skin lesion clinic using teledermoscopy (IMAGE IT trial) , 2009, The British journal of dermatology.

[13]  C Massone,et al.  Teledermatology for skin cancer prevention: an experience on 690 Austrian patients , 2014, Journal of the European Academy of Dermatology and Venereology : JEADV.

[14]  I. Zalaudek,et al.  Pink lesions. , 2013, Dermatologic clinics.

[15]  A. Marghoob,et al.  The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions. , 2012, Journal of the American Academy of Dermatology.