What mole is that? | |
An atlas of surface microscopy of pigmented skin lesions: dermoscopy. Scott W Menzies, Kerry A Crotty, Christian Ingvar, William H McCarthy. Sydney: McGraw-Hill, 2003 (vii + 175pp). ISBN 0 07 471102 4. |
All medical practitioners who examine patients should be able to diagnose early melanoma. The diagnostic algorithm involves ascertaining how long the lesion has been present and whether it has been undergoing change. Examination includes not only observation of the specific morphology of the pigmented lesion in question, but also considering the lesion in the context of other skin lesions that the patient may have.
This book on surface microscopy focuses specifically on the diagnosis of pigmented skin lesions based upon their morphology and, in particular, their morphology when examined with a hand held surface microscope. The authors have data to show that general practitioners achieve a 39% improvement in the sensitivity for the diagnosis of melanoma when using this Atlas. This cannot be specifically interpreted as meaning that fewer melanomas are missed when using this book, but it may translate to fewer benign naevi being excised unnecessarily. Nevertheless, any book that improves diagnostic accuracy has to be welcomed, and this book certainly does that. Examination of pigmented lesions using surface microscopy is a double-edged sword. To the uninitiated, hand held microscopes are confusing and may actually diminish diagnostic accuracy. As such, no general practitioner should pick up a hand held surface microscope without first having read this book. This excellent book is simply written and beautifully illustrated. It is the best of its type in the discipline and the first edition has been widely used by dermatologists and dermatology trainees. The steps to diagnosis are clear and constructive, and the quiz on the CD-ROM that accompanies the book is also very useful. At $94.95, including a CD-ROM, it is excellent value and I recommend it to all general practitioners contemplating the use of a hand held surface microscope. Rodney D Sinclair
 Invasive melanoma - clinical view (a) and surface microscopy (b). Reproduced with permission.
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