SKIN 
 

January 2019     Volume 3 Issue 1 
 

Copyright 2018 The National Society for Cutaneous Medicine 51 

COMPELLING COMMENTS 
 

 
Dermoscopy: Past and Future 
 
Andrew M Armenta, BS1, Alex Steele, BS2, Paul R Massey, MD3 
 
1University of Texas Medical Branch, School of Medicine, Galveston, Texas 
2University of Texas Health and Science Center at San Antonio, School of Medicine, San Antonio, Texas 
3Division of Dermatology, Dell Medical School, University of Texas at Austin, Austin, TX  
 

 
 
In vivo cutaneous microscopy was born in the 
mid-17th century when nascent microscopes 
were employed to examine nailbed vessels 
[1]. In 1878, German physicist Ernst Abbe 
discovered that oil applied to the epidermis 
rendered it translucent [1]. Dermoscopy was 
first applied in the United States by 
dermatologist Jeffrey Michael of Houston, 
Texas in 1922.1 American surgeon Leon 
Goldman described dermoscopy’s 
effectiveness in pigmented skin lesions1 and 
in 1971, Scottish dermatologist Rona MacKie 
argued that dermoscopy could be used to 
distinguish benign and malignant lesions. 1 
 
Despite these advances, widespread use of 
dermoscopy was still limited by impracticality 
(Figure 1). 1 Initially, the size of microscopes 
a limiting factor and the first portable 
dermatoscopes emitted light weakly. In 2001, 
a stronger, polarized light with a cross-
polarization filter was added to the handheld 
dermatoscope1, allowing the viewer to 
examine deeper structures in the skin by 
eliminating reflected light from the highly 
refractive stratum corneum. This advance 
also provided the flexibility to use the 
dermatoscope without contact fluid. 1  
 
Eighty one percent of dermatologists report 
using dermoscopy regularly, including 98% of 
dermatologists recently graduated from 

training2, and the study of dermoscopy has 
evolved to become a field unto itself. The first 
consensus conference on dermoscopy was 
held in 1989. Today the International 
Dermoscopy Society boasts over 13,000 
members from 168 countries, holds annual 
meetings and publishes a journal dedicated 
to dermoscopy.  
 
 
Figure 1: The Zeiss operation microscope utilized by 
Dr. Rona MacKie in a 1971 study on cutaneous 
microscopy. Reproduced with permission from British 
Journal of Dermatology. 
 

 



SKIN 
 

January 2019     Volume 3 Issue 1 
 

Copyright 2018 The National Society for Cutaneous Medicine 52 

Dermoscopy may prove an essential part of 
a virtual evaluation as the practice of 
teledermatology widens. Arzberger et al. 
reported excellent correlation in the 
management decisions of pigmented lesions 
(e.g. self-monitoring, short term follow up, 
excision) between in-person and 
teledermoscopic evaluation in a high-risk 
melanoma cohort, a finding which has been 
replicated in other studies.3 These data 
speak to the potential benefit of 
teledermoscopy for providers and patients 
who may not have in-person access to a 
dermatologist and reflect the bright future of 
dermoscopy in the house of dermatology.  
 
Conflict of Interest Disclosures: None. 
 
Funding: None. 
 
Corresponding Author: 
Paul R. Massey, MD 
Division of Dermatology, Dell Medical School   
Austin, Texas 
prmassey@ascension.org  

References: 
1. Stolz W, Braun-Falco O, Semmelmayer 

U, Kopf A. The Encyclopedia of Visual 
Medicine Series: Atlas of Dermoscopy. 
Abingdon, UK: Taylor &Francis; 2004. 

2. Murzaku, E.C., S. Hayan, and B.K. Rao, 
Methods and rates of dermoscopy usage: 
a cross-sectional survey of US 
dermatologists stratified by years in 
practice. J Am Acad Dermatol, 2014. 
71(2): p. 393-5. 

3. Arzberger E., Curiel-Lewandrowski C., 
Blum A, Chubisov D., Oakley A., 
Rademaker M., Soyer H., Hofmann-
Wellenhof R. Teledermoscopy in High-
risk Melanoma Patients: A Comparative 
Study of Face-to-face and 
Teledermatology Visits. Acta Derm 
Venereol. 2016 Aug 23;96(6):779-83. 

 

 

mailto:prmassey@ascension.org