For any dermatologist, not only the beauty of the skin is important, but also its health. Therefore, the diagnosis and treatment of dermatological diseases is of paramount importance for every specialist in aesthetic medicine. Dermoscopy – this is one of the most informative non-invasive methods for diagnosing skin pathology. Dermatologist Raimonds Karls, chairman of the board of the Latvian Society of Dermatoscopy, member of the International Association of Dermatoscopy, vice-president of the Latvian Association of Aesthetic Laser Surgery, dermatologist Raimonds Karls, told estet-portal.com about the advantages of using dermatoscopy and its modern possibilities.
Why is it so important for a dermatologist to master dermatoscopy?
Actually, the answer is very simple, this is due to the fact that in our time, if we are talking about a dermatoscope – we're talking about a skin stethoscope. The general practitioner "listens" skin and have it examined by a dermatologist. We use magnification and additional lighting, so we get a lot more information. Why is it so important? Of course, we live in the age of dermato-oncology. Therefore, to find, notice in time and neutralize skin cancer in any of its forms, be it melanoma, basal cell carcinoma or any other form, is the primary task of any specialist in the field of aesthetic medicine.
What are the modern types of dermatoscopy?
In our time, we can talk about two main types of dermatoscopy – optical and digital. With the help of optical dermatoscopy, we examine the skin in the "here and now" mode, using the digital — we can document these shots.
Today, we are increasingly using large digital systems that enable us to track neoplasms, monitor patients with multiple nevi, and identify risk groups.
Of course, the future – these are triple dementia (3D) cameras, as well as a cheaper form of confocal microscopy, which will allow even earlier detection of the presence of a tumor.
Which patients especially need dermatoscopy?
In fact, we are all at risk, because we are fair-skinned people - these are I, II and a little III skin phototype. Particular attention should be paid to people over the age of 40 with multiple skin lesions, as well as to patients in whom each neoplasm looks different – with so-called dysplastic nevi. Also at risk are people who have already experienced skin cancer, as well as those who have close relatives with malignant tumors. Other risk factors include tanning beds and prolonged exposure to the sun.
Tell us what is inflamoscopy? When does it apply?
In 1996, when dermatoscopy was just beginning to appear, we were talking about only two diagnoses – melanoma or not melanoma. After 5-7 years, the number of diagnoses was about 20, and at the moment, if we look at world publications, we will see that more than 200 different skin diseases can be diagnosed using dermatoscopy. And, of course, the largest group among them is inflammatory skin lesions. Daily diagnosis of these diseases is not difficult, but sometimes there is a need for differential diagnosis. In this case, dermatoscopy or inflamoscopy comes to the rescue, and helps to make the correct diagnosis in time and start treatment in a timely manner.
Is there a difference in the dermatoscopic picture of young and aging skin?
Yes, there is a difference, both the surface pattern of the skin and its pigmentation change. As I said, dermatoscopy – it is very good lighting and magnification. With optical dermatoscopy, the increase is tenfold, and when using digital systems, you can get an increase of up to 140 times. Dermoscopy gives us the opportunity to see those signs of aging that are not visible to the naked eye. At this stage, we can even say that with the help of dermatoscopy we can control the effectiveness of certain drugs. For example, by prescribing whitening products, we can see changes in the skin during and after treatment.
What do you love most about your profession?
What I love most about my profession is the unpredictability. I have been doing dermatoscopy since 1996, but during this time I have never seen two identical neoplasms, or two identical human skin conditions.
Dermatoscopy is a magical world that opens up new horizons for us every day.
New publications, current teleconsultation opportunities, telecommunications with colleagues in Ukraine, Kazakhstan, Azerbaijan, Georgia and Europe – that's what I like about my profession. Dermoscopy – it is a flag that heralds a whole new era in dermatology.
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