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      "Tape dermatoscopy": constructing a low-cost dermatoscope using a mobile phone, immersion fluid and transparent adhesive tape.

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          Abstract

          Medical professionals and indeed the general public have an increasing interest in the acquisition of dermatoscopic images of suspect or ambiguous skin lesions. To this end, good dermatoscopic image quality and low costs are important considerations.

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          Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting.

          Michael P. Holt, M. Vestergaard, S L Menzies … (2008)
          Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta-analyses including studies performed in experimental and clinical settings. To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta-analysis exclusively on studies performed in a clinical setting. We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15.6 [95% confidence interval (CI) 2.9-83.7, P = 0.016]; removal of two outlier studies changed this to 9.0 (95% CI 1.5-54.6, P = 0.03). Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.
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            Dermoscopic evaluation of amelanotic and hypomelanotic melanoma.

            Margaret Oliviero, Riccardo Bono, Michelle Avramidis … (2008)
            To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma. A total of 105 melanomas (median Breslow thickness, 0.76 mm), 170 benign melanocytic lesions, and 222 nonmelanocytic lesions lacking significant pigment (amelanotic, partially pigmented, and light colored) were imaged using glass-plate dermoscopy devices and scored for 99 dermoscopic features. Diagnostic models were derived from and tested on independent randomly selected lesions. Predominantly hospital-based clinics from 5 continents. Sensitivity, specificity, and odds ratios for individual features and models for the diagnosis of melanoma and malignancy. The most significant negative predictors of melanoma were having multiple (>3) milialike cysts (odds ratio, 0.09; 95% confidence interval, 0.01-0.64), comma vessels with a regular distribution (0.10; 0.01-0.70), comma vessels as the predominant vessel type (0.16; 0.05-0.52), symmetrical pigmentation pattern (0.18; 0.09-0.39), irregular blue-gray globules (0.20; 0.05-0.87), and multiple blue-gray globules (0.28; 0.10-0.81). The most significant positive predictors were having a blue-white veil (odds ratio,13; 95% confidence interval, 3.9-40.0), scarlike depigmentation (4.4; 2.4-8.0), multiple blue-gray dots (3.5; 1.9-6.4), irregularly shaped depigmentation (3.3; 2.0-5.3), irregular brown dots/globules (3.2; 1.8-5.6), 5 to 6 colors (3.2; 1.6-6.3), and predominant central vessels (3.1; 1.6-6.0). A simple model distinguishing melanomas from all nonmelanomas had a sensitivity of 70% and a specificity of 56% in the test set. A model distinguishing all malignant lesions from benign lesions had a sensitivity of 96% and a specificity of 37%. Conclusion Although the diagnostic accuracy of dermoscopy for melanoma lacking significant pigment is inferior to that of more pigmented lesions, features distinguishing the former from benign lesions can be visualized on dermoscopic evaluation.
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              The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions.

              Yevgeniy Balagula, Ralph P Braun, Harold S. Rabinovitz … (2012)
              Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P < .001). The prevalence of CS correlated with increased melanoma thickness (P = .001). Biopsied lesions represent a small percentage of the total number of lesions evaluated. Among biopsied malignant lesions, CS are most commonly observed in basal cell carcinoma and invasive melanomas and rarely seen in nevi. In melanoma, CS may reflect increased tumor thickness and progression. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Dermatol Pract Concept
                Title: Dermatology practical & conceptual
                Publisher: International Dermoscopy Society
                ISSN: 2160-9381
                ISSN (Print): 2160-9381
                Publication date (Electronic): Apr 2015
                Volume: 5
                Issue: 2
                Affiliations
                [1 ] Public, Dermatology, Konstanz, Germany.
                [2 ] Skin Spectrum Medical Services, Como, Western Australia, Australia.
                Article
                Publisher Item ID: dp0502a17
                DOI: 10.5826/dpc.0502a17
                PMC ID: 4462908
                PubMed ID: 26114061
                SO-VID: 2e772a00-f5c8-4f32-9c45-70876ac17794
                History

                Keywords: dermatoscopy,dermoscopy,low-cost,mobile phone,simplified dermatoscopy,tape dermatoscopy,tape dermoscopy,transparent adhesive tape
                Data availability:
                Keywords: dermatoscopy, dermoscopy, low-cost, mobile phone, simplified dermatoscopy, tape dermatoscopy, tape dermoscopy, transparent adhesive tape

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