by: Brian Chau, MS3

The clinical process of evaluating suspicious skin lesions is often taught in medical school through the ABCDE method.

Student physicians are taught to evaluate said lesions based on Asymmetry, irregular Borders, multiple Colors, Diameters > 6mm, and Enlarging lesion.

Dermoscopy is a non-invasive, clinical examination of skin lesions with the aid of a dermatoscope. This process utilizes a liquid medium between a magnifier, a transparent plate, and a polarized light source to allow physicians to better visualize lesions.

It’s an important technique, used by dermatologists to aid in distinguishing between a benign growth and a malignant lesion. For students and residents interested in learning more about this process, Dermoscopy: An Illustrated Self-Assessment Guide app is an attractive option on the iOS.

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Developed by Usatine Media, from Richard Usatine, MD, Dermoscopy: An Illustrated Self-Assessment Guide is based on the textbook with the same name from McGraw-Hill, by Robert H. Johr, MD, (Clinical Professor of Dermatology, Associate Clinical Professor of Pediatrics, Pigmented Lesion Clinic, University of Miami School of Medicine) and Wilhelm Stolz, MD (Director, Clinic of Dermatology, Allergology and Environmental Medicine, Hospital München Schwabing, Professor of Dermatology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany).

It’s important to note that this Dermoscopy app is not a tool to be used as a diagnostic app. There are several “photo” skin lesion diagnostic apps on the market already, such as MelApp.

Instead, this Dermoscopy app is designed to teach the basics of dermoscopy to students and residents, through an introductory text and practice cases.

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Dermoscopy: An Illustrated Self-Assessment Guide is divided into 5 core chapters. The first chapter is an incredibly useful introduction to dermoscopy, with a lengthy section entitled “The Two-Step Algorithm.” This portion covers the process behind analyzing a skin lesion with dermoscopy, core principles and criteria involved in this process. Everything is presented in a very clear-cut, high-yield manner.

Throughout this first chapter, dermoscopy images are shown which correspond to the dermatological concept being discussed. At the end of the first chapter is a multiple-choice quiz over the diagnostic process for different lesions. Browsing this first chapter had me feeling like I was reading a textbook, just with a better layout (especially for the quiz) and sharper images.

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After the first chapter, users will find the remaining chapters to be organized as case question sets, by anatomical region, from head to toe, 191 cases total. Some regions have more cases than others (Trunk/Extremities with 113 cases, Palm/Nose/Nails with 31 cases).

I felt the cases were well laid out, with a presenting history, associated dermoscopy images, and questions following. Most of the questions are true/false, but the final question for each case asks users to rate the risk level of the lesion and select the correct diagnosis from a list. Also, users must choose a disposition–that is, what sort of intervention the patient will require, if any at all.

The introductory text and subsequent cases are really the key features of Dermoscopy: An Illustrated Self-Assessment Guide. There’s a basic search feature, which helps in quickly locating specific cases, plus a preface and foreword from the textbook.

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Overall, I was very impressed with Dermoscopy: An Illustrated Self-Assessment Guide. For me, it served as a very eye-opening guide to the process dermatologists use in evaluating suspicious skin lesions. Not many medical students choose to pursue a career in dermatology, but I feel it’s important to at least have a basic understanding of the complexity involved in such skin lesion analysis. The introductory text was perfect for this purpose and the cases were quite comprehensive. The solid, high-yield feel of a good textbook hasn’t been lost with the transition of this app from text to iOS. The quiz portions load with ease and the images are remarkably detailed.

Dermoscopy: An Illustrated Self-Assessment Guide is available for $94.99, through iTunes. This app requires iOS 3.1.3 or later and runs on the iPod Touch, iPhone and iPad. There is also an Android version available of Dermoscopy: An Illustrated Self-Assessment Guide, along with the previously-mentioned textbook version.

Likes:

  • Superb introduction to dermoscopy on the iOS
  • Excellent layout for easy navigation
  • Detailed dermoscopy images
  • Massive selection of cases

Dislikes:

  • Price may drive some users away, but it’s on par with the textbook version
  • Doesn’t offer cases for some scabies and a few other parasites

Conclusion:

  • Dermoscopy: An Illustrated Self-Assessment Guide is a great example of an excellent textbook-to-app port
  • This app is easy to navigate, covers high-yield material, and offers a large selection of important clinical cases with detailed dermoscopy imagery

Links:

Developer
iTunes