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Dermoscopy: An Illustrated Self-Assessment Guide

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The new textbook, “Dermoscopy: An Illustrated Self-Assessment Guide” by Dr. Robert H. Johr and Prof. Wilhelm Stolz, is a welcome addition to the evolving world of dermoscopic knowledge. I have reviewed all of the images and the text and feel that the contributions are indeed unique. First of all, the exquisite nature of the photographic images deserves a comment. Also, the clarity of labeling for each image separates this text from all others I have seen. Specifically, all of the key features are isolated by means of circles, rectangles, asterisks, etc., and this clear demarcation has succeeded where many similar textbooks fail. Secondly, the questions, statements and the answer format draws the reader into the dialogue. You really cannot escape committing yourself to a diagnosis, or differential diagnosis, as you answer the questions and statements posed. I think these two unique aspects of the textbook serve the learning process in a very positive way.

I should also add that I am an unabashed enthusiast of dermoscopy. Although I presently confine my clinical practice to pediatric dermatology, until 7 years ago, I saw adults on a daily basis and evaluated all of their pigmented lesions with dermoscopy. I have been committed to learning the technique for the last 14 years. Most of that learning curve has involved discussions and teaching by Dr. Robert Johr. Early on, we saw patients with complex pigmentary disorders such as xeroderma pigmentosum and evaluated numerous lesions dermoscopically, helping to separate those lesions which deserved follow-up from those which deserved biopsy. To this day, I continue to use dermoscopy not only to evaluate pigmented lesions in children, but I also use it as an advanced “pocket magnifier”. Specifically, hair shaft disorders, scabies, questionable molluscum lesions, etc., are readily identified when separated out by means of dermoscopy. When I forget my dermascope or when I find it uncharged, I actually feel less qualified to evaluate my patients.

I firmly believe that dermoscopy should be taught as an essential skill in every residency program and that all practitioners should strive to learn this technique. I certainly learned it when I was in my mid 50s, hence, a mature dog can learn new tricks. I am still surprised by the fact that virtually all children referred to me for evaluation of pigmented lesions have not been viewed with dermoscopy by their referring dermatologists. This needs to change. This technique adds a dimension which clearly makes us better diagnosticians and better dermatologists. The book by Drs, Johr and Stolz will help us in this effort.

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