Dr. Hans Koch, the Dermatologist and Urologist, 1921
Melanoma ’s diagnosis is best made on the basis of an excisional biopsy. Suspected melanoma should be removed completely with a vertical and a horizontal margin. Family physicians should be aware that a patient with an atypical mole is at considerable risk for developing melanoma. Dermatologists by careful medical history, clinical examination and dermoscopy can determine the presence of melanoma. The medical history is extremely important, the patient can provide informations about other cases of melanoma in his family, about change of moles (increase in size, change of color and shape). A careful examination by the dermatologist can lead to melanoma ’s diagnosis, but today the development of dermoscopy or epiluminescence microscopy enables the dermatologist to get more and more to an accurate diagnosis of suspected melanoma. The diagnostic accuracy of dermoscopy is significantly better than the use of the naked eye by up to 49 percent depending on the experience of the dermatologist. Melanoma is one of the most aggressive and least treatable cancers, improving diagnostic accuracy by using a dermatoscope can save lives
The use of computerized systems can store images and it allows a careful assessment of pigmented lesions changing over time. Three other techniques are investigated
The reflectance confocal microscopy: it is a high-resolution imaging tool for in vivo non-invasive evaluation of skin lesions. It can play a significant role by improving sensitivity in diagnosis, by increasing rates of successful initial excision, and by serving as a noninvasive means of monitoring therapy. The diagnosis of light coloured lesions was dramatically improved by confocal microscopy compared to dermoscopy. Besides the value of this technique in skin cancer and melanoma diagnosis, it is evident the capability to catch different morphologic aspects that can be correlated with different types melanoma subtypes
Optical coherence tomography and Reflex transmission imaging both normally used for the study of eye injuries and has seen that can help identify early melanoma.