Sunday, August 29, 2010

Which dermatoscope should I buy?

Since the above was written Heine have updated the Delta 20 to have 
both polarised and non polarised light.  See the Heine website

There is also now a DL4 dermatoscope from 3Gen. Magnetic rings allow easy coupling of small digital cameras to the dermatoscope to record images. See Australian DL3 distributer

You can also get attachments for smartphones from both Heine and 3Gen but I still prefer a dedicated setup.





Colours in Dermoscopy

View this YouTube video on Colours. Click on the arrow and when it starts go to the bottom of the screen and change the 360 resolution to 1080 and then click on the box with the arrows pointing out to enlarge to full screen. These videos are recorded in high definition. Press ESC on your keyboard to return to normal size.









                                                                

Kittlerian Terminology

View this YouTube video on Kittlerian terminology. Click on the arrow and when it starts go to the bottom of the screen and change the 360 resolution to 1080 and then click on the box with the arrows pointing out to enlarge to full screen. These videos are recorded in high definition. Press ESC on your keyboard to return to normal size.





Lines



View these YouTube videos on the different types of lines. Click on the arrow and when it starts go to the bottom of the screen and change the 360 resolution to 1080 and then click on the box with the arrows pointing out to enlarge to full screen. These videos are recorded in high definition. Press ESC on your keyboard to return to normal size.



Lines take precedence over other structures and lines reticular is a common structure because we look at a lot of nevi. Remember it is made up of the arrangement of pigmented cells over the dermal papillae (clear holes) and along the sides of the rete ridges (pigmented network).




















Lines radial peripheral represent confluent junctional nests of melanocytes that are rapidly proliferating, They are a feature of Spitz and Reed nevi but when asymmetrically distributed around a pigmented lesion then you should consider melanoma.
Pseudopods are lines radial peripheral with a knob joined to the streak at the end. They are also seen in Spitz, Reed nevi and melanoma. If asymmetrically distributed then consider melanoma and biopsy remove.


View this YouTube video.




View this YouTube video on Lines Parallel










White Lines

White lines are seen in mainly BCCs, invasive melanomas and in Dermatofibromas and scars and some Spitz nevi. They are best seen with a polarising dermatoscope. They may cross each other at right angles.  Some people believe these white lines are just polarising artefacts but I doubt it. Collagen in the dermis is birefringent to polarised light. Sometimes these white lines on a pink background are all you see in a desmoplastic melanoma!


Circles

View this YouTube video on Circles. Click on the arrow and when it starts go to the bottom of the screen and change the 360 resolution to 1080 and then click on the box with the arrows pointing out to enlarge to full screen. These videos are recorded in high definition. Press ESC on your keyboard to return to normal size.




View this YouTube video of Circles in Dermoscopy

View this presentation by Cliff Rosendahl on Grey Circles