What are the limits of dermoscopy?
Dermoscopy allows visualization of the horizontal plane of a given skin lesion only to the level of the papillary dermis. Pathologic structures situated in the reticular dermis cannot be visualized at all (like with the naked eye). Heavily pigmented skin lesions are sometimes very difficult to diagnose, and hypopigmented or amelanotic melanoma represents a particular diagnostic challenge. Very thick tumours may lack a number of dermoscopic features and thus clinical experience and clinical diagnosis remains very important in these lesions. If diagnostic doubt remains with dermoscopy then the lesion should be biopsied. Dermoscopy is not 100%, so do not expect it to be!
