IMAGING IN DERMATOLOGY

Mar
2016
Vol. 35. No. 1

Introduction

Dermatology is a uniquely wonderful field due to its visual nature and the accessibility of the cutaneous surface to be sampled. As such, visual identification of disease by the dermatologist’s eye is a harmonious blend of skill, intelligence, training, and today, technology. 

Dermatology has been adept at adapting technology to augment the visual inspection of the skin. Advancements in optics and light technology have afforded the dermatologist with new tools to noninvasively image cutaneous structures, both macroscopically and microscopically. Dermoscopy has become the standard of care in most dermatologic practices; and while there is a learning curve associated, many dermatologists have embraced this technology. With its widespread availability, there have been numerous studies validating its use and confirming its advantages. 

Similar to dermoscopy, the use of digital imaging, 3D imaging, reflectance confocal microscopy, optical coherence tomography, and ultrasound have allowed dermatologists an enhanced view of the skin. Whether used to monitor nevus progression or noninvasively diagnose, detect, or delineate cancer margins, these devices are changing the practice of dermatology. 

This issue of Seminars in Cutaneous Medicine and Surgery highlights the current state of imaging in dermatology. It is important for the practicing dermatologist to understand the technology that is currently available, both the advantages and the pitfalls of such. Likewise, radiographic imaging, while not historically used, has become the standard of care for certain malignancies, whether for diagnosis, workup, or staging, due to newer advancements in treatment. 

The field of dermatology is experiencing a technologic boom with the advent of devices that can aid in the inspection and diagnosis of cutaneous disease. This trend will continue to be refined and perfected going forward. With the addition of computer intelligence and digital-pattern recognition, the dermatologist of the future may be armed not with a scalpel but rather wearable optics.

Noninvasive imaging for nonmelanoma skin cancer

Cristina Carrera, MD, PhD | Priscila Giavedoni, MD | Susana Puig, MD, PhD

The development of noninvasive optical technologies is revolutionizing the diagnosis of skin tumors. Nonmelanoma skin cancer, the most frequent neoplasm, has become an important health and economic issue, and proper management can avoid unnecessary morbidity and mutilating treatment or relapses. Noninvasive treatment modalities and the recently approved systemic therapies for advanced basal cell carcinoma cases make noninvasive monitoring techniques necessary. Current knowledge, applications, and limitations of the tools most clinically implemented, such as dermoscopy, reflectance confocal microscopy, high frequency ultrasonography, and optical coherence tomography will be reviewed in this article. In addition to the improvement of diagnostic accuracy of skin cancer, using these tools individually or in combination facilitates better management of certain patients and tumors.


Semin Cutan Med Surg 35:31-41 © 2016 Frontline Medical Communications

MORE

Radiographic imaging for skin cancer

Ashley Wysong, MD, MS | Daniel A Belkin, MD

Radiographic imaging is important for the full evaluation of high-risk cutaneous tumors. The correct modality should be chosen based on tumor subtype and clinical question. Locally advanced tumors may require imaging to evaluate the extent of disease, such as bony involvement, orbital infiltration, or perineural invasion. Tumors at high risk for regional and distant metastasis require imaging to identify local and distant tumor burden.


Semin Cutan Med Surg 35:42-48 © 2016 Frontline Medical Communications

MORE