Dermoscopy criteria and histopathological correlation
This chapter describes the dermoscopy criteria and their histopathological correlation
It has the following subchapters:
|Colors seen in Dermoscopy|
|Pigment Network and variants|
|Blue white structures|
|Shiny white structures|
Dermoscopy provides a detailed, horizontal examination of skin lesions, guiding clinicians to the most representative biopsy sites, particularly in extensive lesions. It offers pathologists insight into the most indicative areas for examination, thus enhancing diagnostic accuracy (Bauer et al., 2001; Soyer et al., 2005). This technique's utility extends to ex vivo analysis, where it retains efficacy even post-formalin fixation, illuminating dermoscopic features crucial for evaluating ambiguous melanocytic lesions (Marc Haspeslagh et al., 2016; Scope et al., 2007). Particularly in the absence of clinical data, ex vivo dermoscopy (EVD) can clarify diagnoses, a process further refined by 'derm dotting'—marking points of interest for microscopic examination (Haspeslagh et al., 2013). EVD shows promise in detecting melanomas that conventional methods may overlook, refining melanoma staging, and improving margin detection in keratinocyte carcinomas, potentially expediting diagnosis and reducing histological processing costs (Cabete et al., 2016; Marc Haspeslagh et al., 2016).
In hair and scalp disorders, dermoscopy aids in diagnosis and monitoring, and in pinpointing specific follicles for biopsy, leading to definitive diagnoses in the majority of cases (Richarz et al., 2018; Tosti, 2007; Miteva and Tosti, 2013).
Dermoscopic patterns in melanocytic neoplasms correlate with prognostic factors like mitotic rate and Breslow depth, which can inform treatment strategies (Deinlein et al., 2017; Ribero et al., 2017).
Furthermore, recognizing distinct dermoscopic features can help differentiate skin cancer subtypes, influencing therapeutic decisions. For instance, certain patterns in basal cell carcinoma (BCC) suggest a preference for surgical versus non-surgical approaches (Aimilios Lallas et al., 2014; Ahnlide et al., 2016). Similarly, identifying features in squamous cell carcinoma (SCC) can suggest its differentiation level, guiding treatment choices (A. Lallas et al., 2015; Zalaudek et al., 2012). In melanoma, dermoscopy might even predict specific genetic mutations, pivotal in the era of targeted therapies (Bombonato et al., 2017; Pozzobon et al., 2014; Sanchez et al., 2014). Lastly, dermoscopy serves as a valuable tool in diagnosing and managing skin infections and infestations, tailoring treatments and tracking therapeutic outcomes (Zalaudek et al., 2008).