From the Guidelines
If a dermatologist examines a mole with a dermoscope and isn't concerned, it is generally reassuring, as dermoscopy by an experienced physician enhances the diagnostic accuracy (II, B) 1. When a dermatologist uses a dermoscope to examine a mole, they are looking for specific features that may indicate melanoma, such as asymmetry, border irregularities, color heterogeneity, and dynamics, as outlined in the 'ABCD rule' 1. The use of dermoscopy allows for a more detailed examination of the mole than a visual examination alone, and can improve diagnostic accuracy by allowing the dermatologist to visualize structures not visible to the naked eye. Some key points to consider when a dermatologist examines a mole with a dermoscope include:
- The 'ugly duckling' concept, which suggests that melanomas often do not fit in with the individual's nevus pattern 1
- The importance of monitoring moles for changes over time and returning for follow-up examinations as recommended by the dermatologist
- The need to return for a follow-up visit if any new moles or changes in existing moles are noticed, such as growth, color change, bleeding, or itching. It's also worth noting that while dermoscopy is a valuable diagnostic tool, it is not foolproof, and a biopsy may still be necessary to confirm a diagnosis if the dermatologist is unsure. However, in general, a dermatologist's reassurance after a dermoscopic examination can be considered reliable, as they have the training and expertise to identify suspicious skin lesions and make informed decisions about further testing or treatment.
From the Research
Dermoscopy and Melanoma Diagnosis
- Dermoscopy is a valuable tool for diagnosing melanoma, with studies showing it increases diagnostic accuracy compared to visual inspection alone 2, 3, 4.
- The use of dermoscopy can help identify melanoma at an earlier stage, when it is more treatable 4.
- Dermoscopy can also aid in the detection of other skin cancers, such as keratinocyte carcinomas 4.
Dermatologist's Assessment
- If a dermatologist uses a dermoscope to examine a mole and is not worried, it can be reassuring, as dermoscopy is a reliable tool for assessing skin lesions 2, 3.
- However, it is essential to note that dermoscopy is not foolproof, and a thorough evaluation by a dermatologist is still necessary to determine the best course of action 3.
Limitations of Dermoscopy
- The accuracy of dermoscopy can depend on the observer's experience and expertise 3.
- The use of dermoscopy in primary care settings is still limited, and more research is needed to determine its effectiveness in these settings 3.
- Formal algorithms can be helpful for dermoscopy training purposes and for less experienced observers, but more research is needed to compare different approaches 3.