ORLANDO The field of dermoscopy is expanding rapidly, as demonstrated both by the increase in published papers on the topic in recent years and by the increasing number of uses for the technology, Dr. Brian Katz said at the annual meeting of the Florida Society of Dermatologic Surgeons.
A recent study noted that 450 papers were published on the topic between 2000 and 2005, compared with 100 between 1987 and 1999, said Dr. Katz of Mount Sinai Medical Center, Miami Beach.
His own review of more recent literature showed that about 250 papers on dermoscopy were published in the last year alone.
Additionally, dermoscopy now is being used to predict and/or monitor treatment response in a variety of conditions.
Patients being treated with topical corticosteroids for lichen planus and psoriasis, for example, are being monitored for early signs of atrophy, according to Dr. Katz.
It also appears that patterns seen on dermoscopy in port-wine stains of the face can predict response to pulsed dye laser treatment, Dr. Katz said.
One study of 33 children demonstrated that those with a superficial pattern involving multiple dotted or globularlike vessels were more likely to have a good response. The children with deeper patterns involving linear vessels, which were sometimes reticular in appearance, had much poorer response (Pediatr. Dermatol. 2004;21:58996).
The study also showed that an undefined pattern on dermoscopy was an indication that no further response would be achieved with treatment. This type of finding typically occurred after multiple treatments, and the investigators suggested it should mark the end point of treatment.
Dermoscopy has been shown to be useful in guiding resection of lentigo maligna of the head and neck.
In a study of 26 patients with lesions that clinically appeared to have an uninvolved border, dermoscopy distinguished those with an anular pattern that histologically corresponded to melanoma in situ from those with findings indicative of the melanocytic hyperplasia commonly seen in sun-damaged skin (Arch. Dermatol. 2004;140:1095110).
More recently, dermoscopy has been reported to be useful for monitoring the progress of patients treated with tazarotene for superficial basal cell carcinomas.
In a study of 41 patients, with slightly more than half achieving a complete response, dermoscopy showed progressive loss of dermoscopic structures over the course of treatment until the end point was achieved and all leaflike areas, arborizing vessels, and pink/white background had resolved (Dermatol. Surg. 2005;31:21720).
In a case report published in 2006, dermoscopy was used successfully to monitor the response to imiquimod in a patient treated for lentigo maligna. Over a 12-week treatment course, progressive loss of dermoscopic features of facial lentigo maligna, such as asymmetrically pigmented hair follicle openings and rhomboidal structures around hair follicles, all had resolved (Arch. Dermatol. 2006;142:5301). The patient was followed for 2 years with no recurrence, Dr. Katz said.