Dermoscopy

Dermoscopy is a non-invasive diagnostic method that enables detailed examination of skin lesions using a special optical device – a dermatoscope. This method is most commonly used for the analysis of moles and other pigmented lesions, but also for diagnosing various skin diseases such as skin cancers, benign tumors, keratoses, vascular lesions, and inflammatory dermatoses.

Dermoscopy is now an indispensable tool in modern dermatology because it provides a magnified, illuminated, and clear view of structures within the skin that are not visible to the naked eye. With this examination, the dermatologist can assess whether a skin lesion is benign, suspicious, or potentially malignant – which is crucial for the early detection of melanoma, the most dangerous form of skin cancer.

How is a dermoscopic examination performed?

Dermoscopy is a completely painless, safe, and quick procedure that takes only a few minutes. The dermatologist applies a contact gel or uses polarized light and, with a dermatoscope – a handheld device containing magnifying optics and a light source – examines the suspicious skin lesion in detail. Some devices also enable digital dermoscopy, where images are captured, stored, and compared during follow-up visits.

Dermoscopic examination allows visualization of pigment, capillaries, borders, and the internal architecture of a mole, making it much easier to distinguish benign from malignant lesions. The examination can be performed on all body areas, including the scalp, nails, and mucous membranes.

In digital dermoscopy, specialized software is used to analyze and compare images, enabling monitoring of moles over time and detecting changes that are not visible to the naked eye, which is especially useful in patients with numerous moles or those at risk for melanoma.

When is dermoscopy necessary?

Dermoscopy should be performed when:

• You notice a new mole or a change in an existing mole (change in color, size, shape, indistinct borders)
• A mole begins to bleed, itch, or peel
• An asymmetric pigmented lesion appears on the skin
• You have a large number of moles (more than 50)
• You have a family history of melanoma or other skin cancers
• You have fair skin, blue eyes, light hair – all risk factors for skin cancer
• You are frequently exposed to UV radiation (sun, tanning beds)
• You have had sunburns in childhood
• You have previously been diagnosed with melanoma or another form of skin cancer

Dermoscopy is particularly recommended as a preventive examination once a year, while in high-risk individuals (genetic factors, immunosuppression, numerous moles), more frequent check-ups every 3–6 months are advised.

Advantages of dermoscopy

Dermoscopy is one of the most important steps in the early diagnosis of melanoma and other skin cancers. Early detection of these lesions increases the chances of complete cure and avoids invasive procedures. In addition, dermoscopy enables:

• Avoidance of unnecessary surgical procedures (removal of benign, non-threatening lesions)
• Monitoring the growth and evolution of moles over time
• Better assessment of suspicious lesions without immediate need for biopsy
• Comparison of previous and current findings in chronic skin diseases

Dermoscopy is also useful in inflammatory skin diseases such as psoriasis, dermatitis, rosacea, and some scalp disorders, as it allows more detailed assessment of changes, leading to more precise diagnosis and higher-quality treatment.