Dermoscopic photography
Close-up photograph of a skin lesion, usually with polarised light. Dermoscopic photography allows the observer to see structures and signs of skin cancer not visible to the naked eye, making skin cancers easier to diagnose early. Repeated dermoscopic photos can allow early melanoma diagnosis.

Also known as

serial dermosopic photography, digital imaging, SDDI, sequential digital dermatoscopic imaging

Conditions treated

How it’s performed

Using a dedicated dermoscopic camera, or an illuminated dermoscopic lens attached to a mobile device, a doctor or photographer takes photographs of a skin lesion. Sometimes the area is cleaned first with alcohol, and the photographer may apply oil to the skin to reduce reflection. Photographs are usually automatically imported into image storage software, so that they can be stored securely and viewed on a larger screen. Most image storage software allows side-by-side viewing so that the lesion can be tracked over time and small changes identified.

Preparation

Clean the skin and remove all make-up. Fake tan should not be used for at least 2 weeks before dermoscopic examination and photography.

Side effects and complications

Follow-up

In many cases, the photo is repeated after 3-6 months to detect small changes which might indicate that the lesion is a skin cancer.

Aftercare

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Contraindications

Warnings

Dermoscopic photography significantly increases the ability of the doctor to diagnose early melanoma. However, it is still possible for melanoma and other skin cancers to be missed even with dermoscopic photography repeated at the recommended interval: a low-risk appearance on dermoscopic photography does not always rule out skin cancer. The best way of diagnosing skin cancer is skin biopsy and this procedure should be performed if there is a reasonable suspicion of skin cancer.

Pregnancy

It's safe to undergo this procedure while you are pregnant.

News/blog articles

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Web links

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Manufacturer's brochure

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We take dermoscopic photos of atypical skin lesions: suspicious, unusual-looking or “ugly duckling” spots. These spots don't look like typical skin cancers, but we must consider the possibility that they are.

Improved assessment of your skin lesion

A high-magnification dermoscopic photograph allows better evaluation and diagnosis during your consultation:

  • Your doctor can spend longer looking at and assessing the spot
  • The photo can be analysed using an AI algorithm, which provides a "second opinion". This algorithm has been shown to be as accurate as a dermatologist in certain situations (Esteva 2017).

Sequential dermoscopic photography

If your doctor decides that the spot is unlikely to be a skin cancer, but can't confidently rule out the possibility, you should return to the clinic to have a further photograph taken of the spot in 3 months. This enables us to check for changes that might indicate that the spot is a skin cancer.

If there is no significant change

If the photos show no significant change in your skin lesion, then it is unlikely to be a skin cancer.

This means we have avoided an unnecessary biopsy or excision procedure and any associated costs, scarring and other side effects.

Studies have shown that sequential dermoscopic photography significantly reduces the number of normal moles that are removed (Menzies 2018).

If the skin lesion changes

If the skin lesion changes in the interval between photographs, this can sometimes be a sign that it's a skin cancer. In this event, your doctor may decide to perform an excision biopsy to establish the diagnosis.

This lesion has changed on sequential dermoscopic photography over a period of 3 months. It was biopsied and discovered to be a melanoma in situ (i.e. diagnosed early and cured)

Several studies have shown that melanomas detected on sequential dermoscopic photography are diagnosed much earlier.

This applies for melanomas detected:

  • by the patient or someone they know (Salerni 2014)
  • by a doctor who has not performed sequential photography (Rademaker 2010, Menzies 2018)

You have access to your photos

Your photos are stored in the DermEngine/MoleScope system, which means you have access to them.

If you take your own dermoscopic photos using a magnifying attachment, you have the opportunity to detect skin cancers yourself much earlier than you would otherwise.

If you have your skin checked at another skin clinic in future, you can provide your photos to your new clinic, to give them the opportunity to diagnose skin cancers.

References

Esteva A, Kuprel B, Novoa R, Ko J et al
Dermatologist-level classification of skin cancer with deep neural networks.
Nature volume 542, pages 115–118.
2017
https://doi.org/10.1038/nature21056
Date accessed:
29
Jul 2021
Salerni G, Terán T, Alonso C, Fernández-Bussy R
The role of dermoscopy and digital dermoscopy in the clinical diagnosis of melanoma: clinical and dermoscopic features of 99 consecutive primary melanomas
Dermatology Practical and Conceptual
2014
http://dx.doi.org/10.5826/dpc.0404a07
Date accessed:
22
Jul 2021
Rademaker M, Oakley A
Digital monitoring by whole body photography and sequential digital dermoscopy detects thinner melanomas
Journal of Primary Health Care 2(4) 268 - 272
2010
https://doi.org/10.1071/HC10268
Date accessed:
31
Jul 2021
Menzies S, Guitera P, Soyer P et al
What is the role of sequential digital dermoscopy imaging in melanoma diagnosis?
Clinical practice guidelines for the diagnosis and management of melanoma
2018
https://wiki.cancer.org.au/australia/Clinical_question:What_is_the_role_of_sequential_digital_dermoscopy_imaging_in_melanoma_diagnosis%3F
Date accessed:
22
Jul 2021