‘Home dermoscopy’ tip for telehealth consultations

12 Nov 2020

With telehealth being used in place of face-to-face consultations during the COVID-19 pandemic, skin specialists have suggested a ‘home dermoscopy’ technique to improve recognition of skin lesions via phone images.

The simple technique requires patients to apply fluid such as disinfection spray, cooking oil, or water to the area of the suspect lesion before taking a photo with a mobile phone or digital camera.

The home dermoscopy technique is described by Michelle Menzies, a former Sydney Melanoma Unit researcher who specialises in digital imaging of moles and melanoma surveillance.

Writing in Dermatology Practical and Conceptual, she says that after applying the immersion liquid, the patient should take one to three focused images of the lesion with a camera held at distance of 20–30 cm and an angle of about 45 degrees using ambient indoor or outdoor light for illumination.

When the images are received from the patient in the remote location, the dermatologist can then enlarge the focused images on the computer screen, analyse the visible morphologic features and colours of the upper layers of the epidermis, and make further recommendations, the report authors say.

With co-author Dr Andreas Blum, a dermatologist in Germany, Ms Menzies describe two cases that demonstrate the value of the technique.

In one a 20-year-old male with a new nodular lesion on his shoulder used ‘home dermoscopy’, from which the enlarged image showed dotted vessels and pink colour. Urgent surgery with histopathology was recommended to exclude the spitzoid melanoma or to confirm the benign Spitz nevus.

In a second case a 24-year-old female with a growing lesion on her leg used the fluid technique to obtain images, which when enlarged revealed eccentric streaks and an eccentric hyperpigmentation with dark brown and black colours. Histopathology confirmed the diagnosis of an early invasive melanoma (tumour thickness 0.4 mm).

“It must be mentioned that this simple approach of “home dermoscopy” does not replace medical examination with a real dermatoscope,” the authors say.

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