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When cutaneous lesions are examined by the naked eye, many of the succinct features are obscured by reflection, refraction and diffraction of light, principally by the stratum corneum. By adding a “clearing” medium (e.g. fluid such as oil, gel or alcohol), the stratum corneum is rendered relatively transparent allowing for the visualization of structures that cannot be seen by the naked eye. The ability to visualize these structures significantly improves the in-vivo diagnostic accuracy and allows the clinician to better judge which lesions require biopsy and which do not. The Handbook of Dermoscopy is designed by the editors with two principal goals in mind:
■ to provide a succinct summary coupled with a richly illustrated, comprehensive, dermoscopic atlas
■ to slip into the reader’s pocket for instant availability and ease of portability.
The handbook provides high-quality images of the quintessential features and basic structures which can be identified by dermoscopy and which can be used to differentiate pigmented lesions of the skin. Thus, this microscopic technique is most helpful in assisting the clinician in the diagnosis of melanocytic neoplasms. A rich literature has rapidly accumulated to indicate that adding dermoscopy to the clinical examination substantially improves diagnostic accuracy, which, in turn, reduces the number of biopsies, thus lowering the cost of medical care and unwanted surgical morbidity. In addition, this procedure will build not only your clinical confidence but also that of your patients. Enjoy!!!
Authors’ note viii
1 Structures and colors 1
2 Two-step dermoscopy algorithm 7
3 Non-melanocytic lesions
a. Seborrheic keratoses and lentigo 10
b. Vascular lesions 15
c. Dermatofibroma 18
d. Basal cell carcinoma 19
4 Melanocytic algorithms
a. Pattern analysis 21
b. ABCD rule of dermoscopy 32
c. Seven-point checklist 36
d. Menzies method 39
e. Three-point checklist 43
5 Melanocytic lesions
a. Melanocytic nevi 45
b. Melanoma 55
6 Special locations a.
Face 58 b.
Palms and soles 58 c.
7 Other lesions 67
Further reading 72
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