1. Doctor, is this “mole” anything to worry about?
Rural Track Dermoscopy Workshop
DeWayne Niebur MD
Mark Deutchman MD

2. 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

3. Office visit diagnoses

4. Skin meds are 11th most commonly used

5. Skin cancer – the most common kind of cancer
Basal cell and squamous cell
Melanoma
Merkel cell carcinoma
Lymphomas of the skin
Kaposi’s sarcoma

6. The ABCDE’s of pigmented lesions
A = asymmetry
B = borders
C = color
D = diameter
E = evolving

7. Asymmetry

8. Border irregularity

9. Color variation

10. Diameter > 6mm (pencil eraser)

11. Evolving

12. 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

13. Dermoscope Light source Magnifier
Non-polarized require direct skin contact with gel interface
Polarized does not require direct skin contact

14. Dr. Niebur’s story