An Introduction to Dermoscopy Workshop

This interactive workshop focuses on dermatological assessments and advancing practitioner lesion recognition skills via thorough history taking, visual clues and further investigations to improve patient outcomes.

It includes an introduction to using a dermatoscope in clinical practice and formulating appropriate management plans and referral pathways for cutaneous lesions.

**There will be an opportunity to explore patient case studies (provided by attendees), so please do bring these along to discuss as a group. See below for recommendations on how to present the case study.

 

PRESENTED BY Belinda Longhurst, BSc (Hons), PGCert, FHEA, FFPM RCPS(Glasg)

Belinda qualified as a podiatrist in 2003 and was awarded a First-Class Honours degree with Distinction by the University of Southampton.

She is a Podiatry lecturer for the SMAE Institute`s BSc (Hons) Podiatry degree programme and is a Fellow of both the Higher Education Academy and the Royal College of Physicians and Surgeons of Glasgow.

Belinda has a special interest in Podiatric Dermatology and has frequently presented her published work at both national and international conferences.

She is also a joint course provider for the Royal College of Podiatry Skin Surgery Course (extended scope of practice) and is a Trustee and Volunteer Coordinator for the Registered charity Forgotten Feet, which offers free footcare to the homeless and socially isolated.

Belinda is keen to promote the upskilling of Foot Health Practitioners and Podiatrists in lesion recognition skills to improve the prognosis for people with cutaneous malignancies.

 

 

When presenting a case study the following format is recommended:

Photos (with patient consent):

• Always take at least 2 photos. The first should be an establishing image of the entire foot to identify which part of the foot you are photographing to provide context. Next a close-up image or a series of close-up images should be taken with a scale and then, if possible, an image with a dermatoscope.
• When taking a photograph, the camera needs to be parallel to the lesion. Make sure your cameras macro setting is on and get as close as possible so that the dermatoglyphics (skin lines) can be seen and in focus.

 

Patient and lesion history:

Taking a full history includes noting details of both the patient and the presenting condition. Without these details, it`s a potentially harmful guessing game.

Describe the patient:

• Age
• Occupation (footwear, exposure to carcinogens, allergens)
• Social/recreational activities (smoking, sports, alcohol consumption, etc)
• General medical history (including systemic conditions, allergies, and previous malignancies)
• Current medication (including topical treatments and alternative/herbal therapies)
• Familial medical history (including all auto-immune disorders and malignancies)

Describe the condition (OLD CARTS):

• Onset (rapid, slow, acute, etc)
• Location (anatomically)
• Duration (date it started, how it started, is it continuous or intermittent?)
• Character (describe the *lesion: shape, colour, size, texture, type of pain, itch, etc)
• Aggravating factors (conditions or medications which made it worse)
• Relieving factors (conditions or medications which improved it)
• Treatments (oral and topical meds, duration, and frequency)
• Severity (is it impacting quality of life?)

*A lesion is an abnormal appearance of skin, compared to surrounding skin. Describing the appearance of the lesion provides a systematic approach to compare progression or regression and duration of lesions.

When assessing the character of a lesion, consider:

• Lesion configuration (pattern or shape) – linear, annular, clustered or symmetrical? Raised, flat or fluid-filled? Ulcerative, hyperkeratotic or fissuring?
• Texture – palpate the lesion, is it soft and wobbly or hard and firm? Superficial or deep? Does it blanch? Is it macerated or scaly?
• Colour – red, purple, blue, brown, slate-black, etc
• Morphology - site, distribution & extent of lesions(s)