Layla Tolaymat, MD, FAAD, discusses highlights from her lecture on Using Dermoscopy to Diagnose Pigmented Lesions and How to Diagnose Non-Pigmented Lesions at the 2021 Elevate-Derm Conference.
In this video
Dr. Tolaymat describes dermoscopy as a "sub-macroscopic link" between what the naked eye can see and what the pathologist sees under the microscope. Its purpose, she explains, is to enhance the differential diagnosis and lower the benign-to-malignant biopsy ratio, so clinicians are more likely to biopsy concerning lesions and spare benign ones. She notes the tool is increasingly adopted outside of dermatology, including by family practitioners and PA programs, which makes it all the more important for dermatology specialists and APPs to become experts in its algorithms.
For clinicians who haven't started, she recommends investing in a dermatoscope, attending a dermoscopy-specific conference, and using online resources such as the International Dermoscopy Society. Her favorite self-teaching method: take a clinical photo plus a dermoscopic photo of a lesion, then compare against the pathology when it comes back. She also echoes advice from her mentor, Dr. Harold Rabinovitz — if you're looking through the dermoscope for a long time or keep coming back to a lesion, it "probably ought to come off."
- Dermoscopy is a bridge between clinical exam and pathology that sharpens the differential and lowers the benign-to-malignant biopsy ratio.
- With family practitioners and even PA programs adopting the tool, dermatology clinicians should aim to become true experts in its algorithms.
- To get started: buy a dermatoscope, attend a dermoscopy-focused course, and lean on resources like the International Dermoscopy Society.
- Teach yourself by pairing a clinical and dermoscopic photo of each lesion and comparing them to the returned pathology.
- Trust your gut — if you keep coming back to a lesion or study it for a long time, go ahead and biopsy it.
