DIAGNOSTIC DERMOSCOPY DIAGNOSTIC DERMOSCOPY
Diagnostic Dermoscopy delivers a focused, practical and user-friendly guide to diagnosing the most frequently seen presentations of skin lesions practitioners encounter in clinic. The new edition offers a comprehensive collection of strategies to find and diagnose skin cancers at an earlier point in their evolution, and to increase confidence in diagnosing benign lesions to reduce both patient morbidity and mortality.
The many full-colour illustrations included within are standardised to aid in recognition, while the adjoining dermoscopy images focus on critical diagnostic features which, when combined with the provided clinical information, are sufficient for specific diagnoses or narrow differential diagnoses. The new edition is formatted to aid teledermoscopy education, including many illustrated cases for reference. Diagnostic Dermoscopy offers:
- A comprehensive overview of melanocytic lesions, melanoma presentations, and non-melanocytic lesions
- Thorough explorations of basal cell carcinoma and keratinocyte dysplasia
- Practical discussions of several special sites, including acral, nail, facial, and scalp lesions, as well as trichoscopy
- In-depth examinations of vascular lesions, inflammoscopy for general dermatology, and entomodermoscopy
- Detailed illustrations of genetic and iatrogenic lesions
- Tips from international experts in melanoma diagnosis
Diagnostic Dermoscopy is the ideal resource for dermatologists, primary care physicians, plastic surgeons and allied health practitioners involved in skin lesion and melanoma diagnosis.
Dermoscopy UK
Further information on dermoscopy education, and online courses can be found at www.dermoscopy.co.uk
Table of Contents:
Preface xi
Chapter 1 Introduction 1
Introduction 2
Dermoscopy and diagnosis 3
Dermoscopy principle I – illumination 4
Dermoscopy principle II – magnification 5
Dermoscopy colours I – eumelanin 6
Dermoscopy colours II – non‐eumelanin 7
Imaging modes I – colours 8
Imaging modes II – structures 9
Dermoscopy of normal skin 10
Dermoscopy of photodamaged skin 11
Vascular morphologies 12
Characteristic vascular patterns 13
Polarised dermoscopy – shiny white structures 14
Chapter 2 Melanocytic naevi 15
Early naevi – globular 16
Acquired naevi – reticular 17
Acquired naevi – homogeneous 18
Acquired naevi – evolving 19
Acquired naevi in light skin 20
Acquired naevi in medium-toned skin 21
Atypical melanocytic lesions 22
Atypical melanocytic lesions cases 23
Dermal naevus – pigmented 24
Dermal naevus – hyperpigmented 25
Dermal naevus in dark skin 26
Combined naevus 27
Blue naevus 28
Blue naevus – sclerotic/hypochromic 29
Recurrent naevus 30
Halo naevus 31
Congenital naevus 32
Agminated naevus and naevus spilus 33
Reed naevus I 34
Reed naevus II 35
Pigmented Spitz naevus 36
Hypomelanotic Spitz naevus I 37
Hypomelanotic Spitz naevus II 38
Chapter 3 Melanoma
Chapter 3.1 Melanoma – clinical variants 39
Small diameter 40
Small diameter cases 41
Geometric border 42
Geometric border cases 43
Geographic border 44
Geographic border cases 45
Disordered polarity 46
Disordered polarity cases 47
Naevus-associated 48
Naevus-associated cases 49
Congenital melanocytic naevus-associated 50
Chapter 3.2 Melanoma – pigment variants 51
Multicoloured 52
Multicoloured cases 53
Multicomponent 54
Multicomponent cases 55
Hypermelanotic/hyperpigmented 56
Hypermelanotic/hyperpigmented cases 57
Amelanotic macules 58
Amelanotic macules – cases 59
Amelanotic papules 60
Amelanotic papules – cases 61
Hypomelanotic macules 62
Hypomelanotic macules – cases 63
Hypomelanotic tan plaques 64
Hypomelanotic tan plaques cases 65
Chapter 3.3 Melanoma – dermoscopic features 66
Features of early melanoma 67
Atypical network – focal 68
Atypical network – focal cases 69
Atypical network – multifocal 70
Atypical network – multifocal cases 71
Atypical beaded network 72
Atypical beaded network cases 73
Black dots and globules 74
Black dots and globules cases 75
Eccentric brown blotch 76
Eccentric brown blotch – cases 77
Eccentric black blotch 78
Eccentric black blotch – cases 79
Eccentric grey blotch 80
Eccentric grey blotch – cases 81
Angulated lines 82
Angulated lines cases 83
Negative network 84
Negative network cases 85
Extensive regression 86
Extensive regression cases 87
Focal regression 88
Focal regression cases 89
Blue-whitish veil 90
Blue-whitish veil cases 91
Dermal pigmentation 92
Dermal pigmentation cases 93
Polymorphous vessels 94
Polymorphous vessels cases 95
Skin surface markings 96
Skin surface markings cases 97
Chapter 4 Non- melanocytic lesions 110
Macrocomedone 111
Solar lentigo – fingerprint pattern 112
Solar lentigo – homogeneous pattern 113
Solar lentigo – reticular pattern 114
Solar lentigo – hyperpigmented ‘ink spot’ 115
Solar lentigo – evolving seborrhoeic keratosis 116
Seborrhoeic keratosis – cerebriform pattern 117
Seborrhoeic keratosis – homogeneous pattern 118
Seborrhoeic keratosis – keratotic pattern 119
Seborrhoeic keratosis – hyperpigmented 120
Seborrhoeic keratosis – hypopigmented 121
Seborrhoeic keratosis – irritated 122
Seborrhoeic keratosis – traumatised 123
Seborrhoeic keratosis – clonal 124
Clear cell acanthoma 125
Benign lichenoid keratosis – inflammatory phase 126
Benign lichenoid keratosis – post-inflammatory phase 127
Dermatofibroma 128
Dermatofibroma – hypopigmented 129
Dermatofibroma – hyperpigmented 130
Dermatofibroma – atypical 131
Dermatofibrosarcoma protuberans 132
Neurofibromas 133
Porokeratosis 134
Porokeratosis cases 135
Epidermal naevus 136
Epidermal naevus cases 137
Cutaneous T-cell lymphoma 138
Pseudolymphoma 139
Eccrine poroma 140
Chapter 3.4 Melanoma – high-risk scenarios 98
Late features of melanoma 99
Feature-poor melanoma 100
Feature-poor melanoma cases 101
Nodular melanoma 102
Nodular melanoma cases 103
Amelanotic nodular melanoma 104
Amelanotic nodular melanoma cases 105
Metastatic melanoma 106
Metastatic melanoma cases 107
Rare melanoma subtypes 108
Synchronous melanoma 109
Chapter 5 Basal cell carcinoma 141
Superficial basal cell carcinoma – pink 142
Superficial basal cell carcinoma – pink cases 143
Superficial basal cell carcinoma – pigmented 144
Superficial basal cell carcinoma – pigmented cases 145
Nodular basal cell carcinoma – pink and small 146
Nodular basal cell carcinoma – pink and small cases 147
Nodular basal cell carcinoma – pigmented and small 148
Nodular basal cell carcinoma – pigmented and small cases 149
Nodular basal cell carcinoma – pink and large 150
Nodular basal cell carcinoma – pink and large cases 151
Morphoeic/infiltrative basal cell carcinoma 152
Morphoeic/infiltrative basal cell carcinoma cases 153
basal cell carcinoma 154
Hyperpigmented basal cell carcinoma 155
Seborrhoeic keratosis-like basal cell carcinoma 156
Fibroepithelioma of Pinkus 157
Chapter 6 Keratinocyte dysplasia 158
Actinic keratosis grade I 159
Actinic keratosis grade II 160
Actinic keratosis grade III 161
Actinic keratosis – follicular hyperkeratosis 162
Bowen’s disease – classical 163
Bowen’s disease – hypertrophic 164
Bowen’s disease – pigmented 165
Bowen’s disease – digital 166
Squamous cell carcinoma – white circles 167
Squamous cell carcinoma – keratoacanthoma 168
Squamous cell carcinoma – moderately differentiated 169
Squamous cell carcinoma – ulcerated 170
Squamous cell carcinoma – poorly differentiated 171
Chapter 7 Special sites Periungual warts 194
Onychomycosis 195
Chloronychia – green nails 196
Nail pigmentation – exogenous 197
Capillaroscopy 198
Chapter 7.3 Facial lesions 199
Venous lake 200
Mucosal melanosis 201
Milium/keratin cyst 202
Hidrocystoma 203
Epidermoid cysts 204
Pilomatricoma 205
Sebaceous hyperplasia 206
Sebaceous adenoma 207
Sebaceous naevus 208
Malignant adnexal carcinomas 209
Juvenile xanthogranuloma 210
Granulomatous folliculitis 211
Fibrous papule 212
Trichilemmoma 213
Chapter 7.1 Acral melanocytic lesions 172 Dermal naevus 214
Acquired acral naevi 173
Dermal naevus cases 215
Acral parallel furrow pattern 174
Solar lentigo – fingerprinting 216
Acral lattice pattern 175
Solar lentigo – homogeneous pigmentation 217
Acral fibrillar pattern 176
Solar lentigo – moth-eaten border 218
Congenital acral naevus 177
Ink spot lentigo 219
Acral lentiginous melanoma 178
Benign lichenoid keratosis 220
Acral lentiginous melanoma cases 179
Benign lichenoid keratosis – post-inflammation phase 221
ALM – brown-grey pigmentation 180
Lentigo maligna 222
ALM – brown-grey pigmentation cases 181
Lentigo maligna – annular granular pigmentation 223
Advanced acral lentiginous melanoma 182
Lentigo maligna – circles 224
Lentigo maligna – perifollicular pigmentation 225
Lentigo maligna – young adults 226
Chapter 7.2 Onychoscopy 183 Lentigo maligna melanoma – I 227
Nail matrix naevi 184
Lentigo maligna melanoma – II 228
Nail apparatus melanoma in situ 185
Early invasive nail apparatus melanoma 186
Advanced nail apparatus melanoma – pigmented 187 Chapter 7.4 Scalp lesions 229
Advanced nail apparatus melanoma – non-pigmented 188 Scalp naevus – dermal 230
Nail apparatus squamous cell carcinoma 189
Scalp naevus – junctional 231
Erythronychia 190
Scalp naevus – blue 232
Onychopapilloma 191 Scalp naevus – reticular homogeneous 233
Subungual haematoma 192 Scalp seborrhoeic keratosis 234
Subungual haematoma cases 193 Scalp seborrhoeic keratosis cases 235
Scalp melanoma – thin 236
Scalp melanoma – thin cases 237
Scalp melanoma – thick 238
Scalp metastases 239
Scalp basal cell carcinoma 240
Scalp basal cell carcinoma cases 241
Scalp B-cell lymphoma 242
Scalp cylindromas/spiradenomas 243
Scalp sarcoidosis 244
Chapter 7.5 Trichoscopy 245
Alopecia areata 246
Androgenetic alopecia 247
Frontal fibrosing alopecia 248
Lichen planopilaris 249
Discoid lupus erythematosus 250
Tufted folliculitis 251
Steroid-induced telangiectasia 252
Pseudopelade 253
Circle hairs 254
Trichostasis spinulosa 255
Picker’s nodule 256
Traction/frictional alopecia 257
Pseudonits 258
Chapter 8 Vascular lesions 259
Telangiectasia 260
Spider telangiectasia 261
Subcorneal haematoma – parallel pattern 262
Subcorneal haematoma – parallel pattern cases 263
Subcorneal haematoma – homogeneous pattern 264
Subcorneal haematoma – homogeneous pattern cases 265
Haemangiomas – red 266
Haemangiomas – purple 267
Angiokeratomas 268
Lymphangiomas 269
Pyogenic granulomas 270
Pyogenic granulomas – acral cases 271
Vascular tumours 272
Purpura – traumatic 273
Chapter 9 Inflammoscopy 274
Mastocytosis 275
Acne 276
Rosacea 277
Eczema 278
Psoriasis 279
Lichen planus 280
Lichen planus pigmentosus 281
Capillaritis 282
Vasculitis 283
Granulomatous conditions 284
Granuloma annulare 285
Tinea corporis 286
Pityriasis rosea 287
Cutaneous lupus erythematosus 288
Chapter 10 Genodermatoses 289
Gorlin syndrome 290
Cowden syndrome 291
Birt-Hogg-Dubé syndrome 292
Familial cylindromatosis syndrome 293
Muir-Torre syndrome 294
Reed syndrome 295
Familial melanoma 296
Carney complex 297
Chapter 11 Entomodermoscopy 298
Delusional parasitosis 299
Scabies – Sarcoptes scabiei 300
Scabies cases 301
Head lice – Pediculosis capitis 302
Bed bugs – Cimex lectularius 303
Tick bites – Ixodidae 304
Leishmaniasis 305
Molluscum contagiosum 306
Viral warts – Verrucae vulgaris 307
Sea urchin – Echinoidea 308
Jellyfish – Cnidaria 309
Tungiasis – Tunga penetrans 310
Myiasis – Dermatobia hominis 311
Chapter 12 Miscellaneous 312
Keloids and hypertrophic scars 313
Foreign body 314
Foreign body cases 315
Exogenous pigmentation 316
Exogenous pigmentation cases 317
Laser 318
Cryotherapy 319
Radiotherapy 320
Index 321
About the Author :
Jonathan Bowling, MBChB FRCP Consultant Dermatologist, Oxford, UK.
John Paoli, Ph.D. Professor, Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; and Consultant Dermatologist, Sahlgrenska University Hospital, Gothenburg, Sweden.
Alex Chamberlain, MB BS (Hons) FACD Adjunct Senior Lecturer, Central Clinical School, Monash University; and Specialist Dermatologist, Victorian Melanoma Service, Alfred Health, Prahran, Victoria, Australia.
