Skin Cancer Screening and Dermoscopy

Skin cancer evaluation is not simply about looking at a single mole. It requires a comprehensive assessment of individual and family risk, the number and pattern of moles, sun damage, and suspicious lesions. In high-risk patients, the frequency of follow-up is individualized.

Dermoscopy is a non-invasive method that helps to visualize pigment and vascular structures that are not visible to the naked eye by evaluating skin lesions under magnified and special lighting. When used by a trained clinician in melanoma evaluation, it significantly increases diagnostic accuracy compared to naked-eye examination.

Dermoscopy is not only used for moles; it can be helpful in melanoma, basal cell carcinoma, squamous cell carcinoma, actinic keratosis, and numerous benign or inflammatory lesions.

Dermoscopy is not a substitute for histopathology. Biopsy or appropriate excision may be necessary for suspicious lesions. In cases of suspected melanoma, diagnostic biopsy is planned to be deep enough to allow reliable assessment of Breslow thickness and to sample as much of the lesion as possible.

In high-risk patients with numerous or atypical nevi, total body photography and sequential digital dermoscopic imaging can help track changes in selected lesions over time. The goal is not to remove all moles, but to more accurately identify those that are changing or suspicious.

The evidence is insufficient to justify routine screening at the same intervals for everyone in the general asymptomatic population; however, this does not negate the value of regular dermatological monitoring in high-risk individuals.