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Updated: Jul 21, 2021

Dermatoscopy refers to the examination of the skin using skin surface microscope. It is mainly used to evaluate pigmented and non pigmented skin lesions.

It is an essential skill to acquire in order to improve accuracy and specificity of detecting melanoma.

Below is a dermatoscopic view of a pigmented lesion on the left posterior shoulder of a middle aged man. It was totally asymptomatic, and was picked up during a routine screening skin check. Like any other pigmented lesion, this lesion was viewed under submersion dermatoscopy (submersion: means putting a film of fluid between the dermatoscope and the skin to eliminate glare, which can also be achieved with polarised light), and this was what I saw: irregular in colour and structure ("Chaos"), with grey colour in the periphery (6 and 9 o'clock) and structureless areas. It was subsequently excised with 2 mm margin for pathology, and the report came back to be a melanoma insitu. "Insitu" refers to when the melanoma is still within the epidermis (the top layer of skin), which has a much better prognosis than any other melanoma.

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