Problem Faced
Some sites like body folds and deeper mucosal areas are not easily amenable to dermoscopy because of the inherent shape of the presently available dermoscopes, especially the handheld ones, and more so in the context of contact dermoscopy. The use of USB dermoscopes and modified arthroscopes to explore mucosa has been described previously for contact mucoscopy.[1,2]
Solution Proposed
We tried using a handheld rigid otoendoscope for dermoscopy for focused contact dermoscopy of less accessible sites (such as interdigital spaces and mucosa), because of the longer and thinner shape, as compared to normal handheld dermoscopes. The otoscope (Vaansari Marketing services™; 2.7 mm diameter; 100 mm length; cost approximately 25000 INR) was attached to a mobile phone camera with a simple adapter to take images [Figure 1]. The advantages are that it does not need a separate monitor for viewing or capturing images (unlike USB dermoscopes), the tip can be sterilized easily with alcohol solution, and most importantly its thin and long shape allows access to difficult areas. The otoscope was useful for the visualization of skin lesions as well as nail fold capillaries [Figure 2].
Figure 1.
(a) Rigid otoscope attached to a mobile phone camera; (b) using the rigid otoscope for mucoscopy
Figure 2.
(a) Dermoscopy of periungual viral wart using the rigid otoscope, showing the thrombosed capillaries. (2) Nail fold capillaroscopy using the rigid otoscope (alcohol gel was used as the contact fluid; images were taken with a Samsung® S8 plus phone)
The limitation, however, was that it was not easy to focus the images for capturing photographs because even mild movement leads to significant blurring. Moreover, the otoscopy did not have an inbuilt magnification, hence, the magnification is essentially the digital zoom of the attached camera. We feel that dermoscope manufacturers should consider incorporating options for either adapters or dermoscopes with longer and thinner end-pieces, which will help in the dermoscopy of difficult to access sites.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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- 2.Sakamaki H, Kondoh T, Takeda Y, Yamazaki Y, Nogami T, Tobe M, et al. Development of contact mucoscopy for oral mucosal diseases; a preliminary report. J Jap Soc Oral Muc Memb. 2007;13:8–15. [Google Scholar]