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Skin Cancer Diagnosis: Utilizing Dermatoscopy and Excisional Biopsy for Melanoma and Basal Cell Carcinoma

Close-up of a dermatology consultation: a middle-aged Hispanic patient on an examination table, with a Hispanic dermatologist using a dermatoscope to examine an irregular mole on the patient's forearm. The well-lit room features medical tools and a computer displaying a digital image of a skin lesion, highlighting the importance of skin cancer diagnosis, including the ABCDE of melanoma and the role of excisional biopsy in identifying basal cell carcinoma.

The skin cancer diagnosis process is critical and requires precision and attention to detail. Dermatoscopy has become an essential tool in evaluating suspicious skin lesions, allowing physicians to identify features that are not visible to the naked eye. This non-invasive method enhances sensitivity in detecting skin cancers, such as basal cell carcinoma and melanoma, while reducing the number of unnecessary biopsies of benign lesions.

Diving Deeper into Dermatoscopy and Biopsy

Dermatoscopy, also known as dermoscopy, is particularly useful in the early detection of melanoma, where specific melanoma criteria may be invisible to the naked eye. The use of polarized and non-polarized dermatoscopes is recommended for examining lesions, as this has led to the discovery of new diagnostic criteria [1]. Furthermore, dermatoscopy has proven effective in identifying keratinocyte carcinomas, such as squamous cell carcinoma, in its early stages [2].

The use of dermatoscopic triage algorithms assists physicians in deciding when it is most appropriate to perform an excisional biopsy or a referral [3]. Biopsy remains the gold standard for confirming a skin cancer diagnosis, allowing for detailed histopathological evaluation. The correlation between dermatoscopic and dermatopathological findings is crucial for effective communication between the clinician and the pathologist [4].

Conclusions

The integration of dermatoscopy into daily clinical practice has revolutionized skin cancer diagnosis, improving accuracy and reducing the need for unnecessary biopsies. The ability to identify thinner melanomas and differentiate between benign nevi and melanomas has been a significant advancement in dermatology. As technology advances, the use of dermatoscopic images for machine learning and automated diagnosis promises to further enhance diagnostic accuracy, coexisting fruitfully with human experts.

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Created 6/1/2025