INTRODUCTION TO DERMOSCOPY - 03/09/11

Doi : 10.1016/S0733-8635(05)70263-1

Brian Katz, BA ^{^{*
Department of Dermatology, University of Miami School of Medicine, Miami; and Skin and Cancer Associates, Plantation, Florida}}, Harold S. Rabinovitz, MD ^{^{*
Department of Dermatology, University of Miami School of Medicine, Miami; and Skin and Cancer Associates, Plantation, Florida}}

Résumé

Dermoscopy, also called dermatoscopy, epiluminescence microscopy, and surface microscopy, is a noninvasive technique allowing magnified examination of pigmented lesions of the skin. By using an illuminated hand-held microscope with oil applied to the skin surface, light reflection is reduced rendering the stratum corneum translucent. This translucency allows detailed visualization of the structures contained within the epidermis, dermoepidermal junction, and papillary dermis, all of which are not visible to the naked eye (Figure 1).³⁵

Johan Christophorus Kolhaus was the first to experiment with skin-surface microscopy in 1663 in the examination of blood vessels.^{7Menzies S., Crotty K., Ingvar C., McCarthy W. An Atlas of Surface Microscopy of Pigmented Skin Lesions Sydney: McGraw-Hill (1996).

Cliquez ici pour aller à la section Références} In the 1950s, Leon Goldman described the usefulness of this technique in the investigation of pigmented skin lesions.^{7Menzies S., Crotty K., Ingvar C., McCarthy W. An Atlas of Surface Microscopy of Pigmented Skin Lesions Sydney: McGraw-Hill (1996).

Cliquez ici pour aller à la section Références} In 1971, Rona MacKie finally recognized the importance of surface microscopy for the differentiation of benign and malignant skin lesions in preoperative diagnosis. The development and practical clinical application of dermoscopy was hindered by the necessity for a rather large microscope, however, a necessity that was overcome with the invention of the dermatoscope.^{13Stolz W. Dermatoscopy: A Useful Technique for the Preoperative Evaluation of Pigmented Skin Lesions Nederlands Tijschrift voor Dermatologie & Venereologie 1996 ; 6 : 257-260

Cliquez ici pour aller à la section Références} The invention of this illuminated hand-held microscope with a fixed magnification of 10-fold allowed the identification of distinct pigmentation and structural patterns. Through evaluation of thousands of different pigmented lesions by several research groups at different medical centers around the world, diagnostic criteria have been verified and the nomenclature standardized and simplified for the practicing dermatologist. With the use of this established diagnostic criteria, dermoscopy clearly has been shown to significantly enhance the accuracy of clinical diagnosis of all pigmented lesions of the skin.^{7Menzies S., Crotty K., Ingvar C., McCarthy W. An Atlas of Surface Microscopy of Pigmented Skin Lesions Sydney: McGraw-Hill (1996).

Cliquez ici pour aller à la section Références}

In dermoscopy, correct identification of these standardized pigmentation and structural patterns, along with a basic understanding of their histologic correlates, are fundamental to the most accurate assessment of a pigmented lesion.

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