Differences Between Polarized Light Dermoscopy and Immersion Contact Dermoscopy for the Evaluation of Skin Lesions

Benvenuto-Andrade, Cristiane; Dusza, Stephen W.; Agero, Anna Liza C.; Scope, Alon; Rajadhyaksha, Milind; Halpern, Allan C.; Marghoob, Ashfaq A.

doi:10.1001/archderm.143.3.329

“…However, there are some differences when comparing PD with NPD 8,10 . In general, the PD allows better visualization of structures deep in the skin, like blood vessels.…”

Section: Discussionmentioning

confidence: 99%

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Wang

¹

,

Dusza

²

,

Scope

³

et al. 2008

Dermatologic Surgery

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Objective: To evaluate whether the differences in colors and structures observed in dermoscopic images from non-polarized dermoscopes (NPD) and polarized dermoscopes (PD) can impact physicians' diagnostic ability and their confidence levels.Participants: 100 dermatologists who attended a one-day course on the fundamental of dermoscopy course at Memorial Sloan-Kettering Cancer Center.Design: Twenty five pigmented lesions were chosen, which consisted of 7 seborrheic keratoses, 3 basal cell carcinomas, 2 atypical nevi, 5 melanomas, 3 dermatofibromas, 3 blue nevi and 2 hemangiomas. Two images of each lesion (one NPD and one PD) for a total of 50 lesions were included in the image presentation. Participants were not informed of the study design and were not told that they would be viewing the same lesions under 2 different imaging modalities. Statistical analysis examining the participants' responses was performed using the McNemar's test and Paired t test.Main Outcome Measures: The main outcomes included the assessment of the diagnostic accuracy and confidence level for clinicians viewing lesions via NPD and PD.Results: Ninty-one participants completed the study. Statistically significant differences in the diagnoses were observed in the seborrheic keratosis, atypical nevus and melanoma groups. For seborrehic keratosis, 75% and 59% of the final participants correctly diagnosed SK when presented with the NPD and PD images, respectively. For atypical nevi, 19% and 33% had the correct diagnoses when presented with NPD and PD images, respectively. For melanomas, 23% and 34% had correct diagnoses with the NPD and PD images, respectively. For the categories of seborrehic keratosis and atypical nevus, participants were statistically more confident in their diagnoses when presented with the NPD images than with the PD images. For the category of basal cell carcinoma, participants were more confident in their diagnosis when viewing the PD images compared to the NPD images.Conclusion: There are observed differences between NPD and PD in term of the color and structure visualized. In some cases, physicians diagnostic accuracy and confidence are affected by the differences seen with the different dermoscopes. NPD and PD appears to provide different but complementary information.

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“…However, studies have demonstrated some striking differences in the colors and dermoscopic structures observed with NPDs and PDs 8,10 . In this study, we evaluated whether these differences can impact physicians' diagnostic accuracy and confidence levels in examining pigmented skin lesions.…”

Section: Introductionmentioning

confidence: 99%

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level

Wang

¹

,

Dusza

²

,

Scope

³

et al. 2008

Dermatologic Surgery

Self Cite

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Objective: To evaluate whether the differences in colors and structures observed in dermoscopic images from non-polarized dermoscopes (NPD) and polarized dermoscopes (PD) can impact physicians' diagnostic ability and their confidence levels.Participants: 100 dermatologists who attended a one-day course on the fundamental of dermoscopy course at Memorial Sloan-Kettering Cancer Center.Design: Twenty five pigmented lesions were chosen, which consisted of 7 seborrheic keratoses, 3 basal cell carcinomas, 2 atypical nevi, 5 melanomas, 3 dermatofibromas, 3 blue nevi and 2 hemangiomas. Two images of each lesion (one NPD and one PD) for a total of 50 lesions were included in the image presentation. Participants were not informed of the study design and were not told that they would be viewing the same lesions under 2 different imaging modalities. Statistical analysis examining the participants' responses was performed using the McNemar's test and Paired t test.Main Outcome Measures: The main outcomes included the assessment of the diagnostic accuracy and confidence level for clinicians viewing lesions via NPD and PD.Results: Ninty-one participants completed the study. Statistically significant differences in the diagnoses were observed in the seborrheic keratosis, atypical nevus and melanoma groups. For seborrehic keratosis, 75% and 59% of the final participants correctly diagnosed SK when presented with the NPD and PD images, respectively. For atypical nevi, 19% and 33% had the correct diagnoses when presented with NPD and PD images, respectively. For melanomas, 23% and 34% had correct diagnoses with the NPD and PD images, respectively. For the categories of seborrehic keratosis and atypical nevus, participants were statistically more confident in their diagnoses when presented with the NPD images than with the PD images. For the category of basal cell carcinoma, participants were more confident in their diagnosis when viewing the PD images compared to the NPD images.Conclusion: There are observed differences between NPD and PD in term of the color and structure visualized. In some cases, physicians diagnostic accuracy and confidence are affected by the differences seen with the different dermoscopes. NPD and PD appears to provide different but complementary information.

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“…9,10 In addition, dermoscopy has been shown to improve diagnostic accuracy of nonpigmented skin malignancies. 11,12 Dermoscopic evaluation can be performed with non-polarized light contact dermoscopy, polarized light contact dermoscopy or polarized light non-contact dermoscopy. It is imperative that the users of these techniques should be aware of the subtle differences in color and structures between polarized and non-polarized images to avoid misdiagnosis.…”

Section: Dermoscopy and Videodermoscopymentioning

confidence: 99%

“…Unlike non-polarized light dermoscopy, polarized light dermoscopy allows visualization of deep skin structures without the necessity of a liquid interface or direct skin contact with the instrument. 12 One of the differences between polarized dermoscopy and non-polarized dermoscopy is the ability to visualize white shiny structures using polarized light contact dermoscopy or polarized light non-contact dermoscopy. Three defined morphologies may be present by white shiny structures and include white shiny lines, white shiny areas and rosettes.…”

Section: Dermoscopy and Videodermoscopymentioning

confidence: 99%

Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma

Warszawik-Hendzel

¹

,

Olszewska

²

,

Maj

³

et al. 2015

J Dermatol Case Rep

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Squamous cell carcinoma is the second most common cutaneous malignancy after basal cell carcinoma. Although the gold standard of diagnosis for squamous cell carcinoma is biopsy followed by histopathology evaluation, optical non-invasive diagnostic tools have obtained increased attention. Dermoscopy has become one of the basic diagnostic methods in clinical practice. The most common dermoscopic features of squamous cell carcinoma include clustered vascular pattern, glomerular vessels and hyperkeratosis. Under reflectance confocal microscopy, squamous cell carcinoma shows an atypical honeycomb or disarranged pattern of the spinous-granular layer of the epidermis, round nucleated bright cells in the epidermis and round vessels in the dermis. High frequency ultrasound and optical coherence tomography may be helpful in predominantly in pre-surgical evaluation of tumor size. Emerging non-invasive or minimal invasive techniques with possible application in the diagnosis of squamous cell carcinoma of the skin, lip, oral mucosa, vulva or other tissues include high-definition optical coherence tomography, in vivo multiphoton tomography, direct oral microscopy, electrical impedance spectroscopy, fluorescence spectroscopy, Raman spectroscopy, elastic scattering spectroscopy, differential path-length spectroscopy, nuclear magnetic resonance spectroscopy, and angle-resolved low coherence interferometry. (J Dermatol Case Rep. 2015; 9(4): 89-97)

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Differences Between Polarized Light Dermoscopy and Immersion Contact Dermoscopy for the Evaluation of Skin Lesions

Cited by 208 publications

References 20 publications

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level

Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma

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