Color Atlas of Dermoscopy

A trip to the dermatologist’s office on a regular basis is always useful. Should we notice one of our moles changing its appearance, for example, we’d better have it checked. Don’t be afraid. Dermatologists have now a reliable, non-invasive method at their disposal: DERMOSCOPY. Dermoscopy has been defined the millennium method, since it is fast, easy to apply and convenient. There is also a hint of oriental wisdom at the basis of Dermoscopy. According to traditional oriental medicine, a good doctor should be able to make a diagnosis even just looking at the patient. Indeed, the careful and methodical observation, with the help of a dermatoscope (a simple optical lens) of skin lesions, has allowed dermatologists to discover many new models of pigmented and-non pigmented lesions and today Dermoscopy represents the standard for the diagnosis of melanoma and skin tumors in general diagnosis of lesions and skin cancers. 

Dermoscopy philosophy

“Here is my secret. It’s very simple. It is only with the heart that one sees well. The essential is invisible to the eye”
(Antoine de Saint Exupéry).

For a long time, the only diagnostic tool available to dermatologists has been a careful look and experience in identifying and interpreting the structural changes of the skin surface. Although the microcosm of dermoscopic colors and structures known today has always been before the eyes of previous generations of derma-tologists, their eyes could not recognize them. 

The quote “beauty lies in the hidden” admirably describes how dermoscopy has influenced the history of dermatology. 

With the help of a simple optical lens, called dermatoscope, a new and unknown morphological dimension of skin lesions opened to dermatologists. 

Since then, researchers have deepened the study of this new morphological di-mension, with the constant discovery of new morphological models of pigmented and non-pigmented skin lesions. 

Dermatoscopy can rightly be considered the millennium method. The fact that it is fast, reliable, cheap, easy to carry and apply, explains its success worldwide. Today it represents the standard method for the diagnosis of skin tumors and lesions in general dermatology. 

Once you start using dermoscopy, you won’t leave it. 

How can we explain that such a simple method is so addictive and contagious? We could answer this question from an objective or personal scientific point of view. 

There is more and more evidence that dermoscopy improved the diagnostic accuracy, influencing the management of the patient and increasing diagnostic confidence. Furthermore, dermoscopy allows the observation of in vivo skin tumors and their observation over time, which has opened up new knowledge on the behavior and biology of melanocytic tumors. 

But what is the value of dermoscopy for users? Here is an excerpt of the answers to the question “why do you love dermatoscopy” by postgraduate students, members of the editorial committee of Dermatology Practical & Conceptual and members of the executive committee of the International Dermoscopy Society: 

“it is a particular and constantly evolving science - its potential lifesaver – it is the study of detail - it is a bridge between dermatology and pathology - I’m not good at anything else - quick, simple, safe and accurate diagnosis, what more can you ask
for? - it is full of surprises - it is a way of living and thinking - it is passion and pure love for what one does - it is the love for morphology -is a simple way to ex-plain the pathophysiology of a disease - it is an analytical and aesthetic commit-ment – it makes us better clinicians and scientists – it can be applied by everyone – it is fast – it is magic - looking at anything through a magnifying glass is fun and exciting - people and the sense of community – it allowed me to meet a lot of friends and improve my skills every day, month, year - I don’t like dermoscopy but I practice it. However, what I love is the people of dermatoscopy - it meets the 3 B in Spanish: bueno, bonito y barato - the community it created – it helps me provide the best care for my patients. In essence, it has contributed greatly in making my work days more pleasant and less stressful - it is an integral part of my life. It allowed me to give better care to the patient, hold conferences all over the world, collaborate with others who have become dear friends, so I love what der-moscopy has done for me - I love dermoscopy because it gave me love ...... ”. 

From all these answers, it is clear that dermoscopy is more than a simple diagnostic method. For me, dermoscopy is a kind of philosophy and a way of practicing our profession. It connects people who have one common goal in the health sector: to give the best for the well-being of patients. 

The book you are holding has been written by esteemed colleagues with whom I have had the honor of working with for many years and with whom I have experienced many beautiful moments. They are not only experts in their field, but also excellent teachers. 

With this book they share their knowledge and enthusiasm for dermatoscopy and for the good of our patients. 

I am convinced that, at the end of the book, you will find your answer to the question “why do I love dermoscopy?”. 

I wish you a good reading. 

Prof. Iris Zalaudek
Director of the Dermatological Clinic
Medical Surgical and Health Sciences Department
University of Trieste
Ospedale Maggiore di Trieste, Italy