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Dermoscopy of pigmented skin lesions* (Part II)


European Journal of Dermatology. Volume 11, Numéro 5, 483-98, September - October 2001, Articles FMC

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Auteur(s) : H. Peter SOYER, Giuseppe ARGENZIANO, Vincenzo RUOCCO, Sergio CHIMENTI

Résumé : Dermoscopy is a non-invasive technique combining digital photography and light microscopy for in vivo observation and diagnosis of pigmented skin lesions. For dermoscopic analysis, pigmented skin lesions are covered with liquid (mineral oil, alcohol, or water) and examined under magnification ranging from x 6 to x 100, in some cases using a dermatoscope connected to a digital imaging system. The improved visualization of surface and subsurface structures obtained with this technique allows the recognition of morphological structures within the lesions that would not be detected otherwise. These morphological structures can be classified on the basis of both global features, allowing a quick, albeit only preliminary categorization of a given pigmented skin lesion, and local features, representing the letters of the dermoscopic alphabet. Classification of melanoma-specific dermoscopic criteria - namely, atypical pigment network, irregular dots/globules, irregular streaks, blue-whitish veil and regression structures, to name the most important ones - forms the basis of diagnostic algorithms designed to aid the clinician in assessing whether or not a melanocytic lesion is melanoma. A certain number of lesions defy both clinical and dermoscopic diagnosis, and in those cases the ultimate standard for diagnosis is histopathology, especially when performed by well-trained and competent dermatopathologists.

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