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Doctor, is this “mole” anything to worry about?
Rural Track Dermoscopy Workshop DeWayne Niebur MD Mark Deutchman MD
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Skin problems are common and a frequent cause for visits.
Number of U.S. office visits: 1.0 billion Number of visits per 100 persons: 332.2 Percent of visits made to primary care physicians: 55.5% Skin problems are in the top 10 reasons for office visits
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Office visit diagnoses
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Skin meds are 11th most commonly used
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Skin cancer – the most common kind of cancer
Basal cell and squamous cell Melanoma Merkel cell carcinoma Lymphomas of the skin Kaposi’s sarcoma
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The ABCDE’s of pigmented lesions
A = asymmetry B = borders C = color D = diameter E = evolving
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Asymmetry
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Border irregularity
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Color variation
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Diameter > 6mm (pencil eraser)
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Evolving
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Can we do better with dermoscopy?
Magnifies and illuminates skin features Brings subsurface structures into view Helps differentiate benign from cancerous: Melanocytic V. non-melanocytic Nevi from melanomas
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Dermoscope Light source Magnifier
Non-polarized require direct skin contact with gel interface Polarized does not require direct skin contact
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Dr. Niebur’s story
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