Biomechanical faults affect melanocytic lesions but what about considering their affects on non melanocytic structures such as vascular tissues

These are questions and ideas I thought of myself. If shearing forces can affect the parallel furrow pattern why can’t similar forces affect other structures besides those seen in a melanocytic lesion? For example in a basil cell carcinoma why can’t shearing forces cause an arborizing vessel appearance to instead appear as polymorphous or dotted? Or why can’t the blue-white veil overlying raised area instead appear homogenous? Or why can’t a typical network appear atypical? Or why can’t a regular globular pattern appear irregular?

Why is a lattice pattern instead of a parallel furrow pattern present on the arch which clinically without a biomechanical analysis would appear non weightbearing? One cannot just look at the arch and assume it is non weight bearing.

The answer to this puzzle is that the biomechanical exam yields information unknown to only a dermatoscopic exam. There are different biomechanical faults in different planes be it your sagittal, transverse and frontal planes. Some of these faults occur on the rearfoot, some on the forefoot while some are uncompensated, partially compensated and fully compensated.

Key: After a complete biomechanical evaluation and fully checking the shoe gear and insoles, if there is a biomechanical deformity (with or without any degree of compensation) which results in biomechanical non weight bearing area with very limited shearing forces, plus a dermatoscopic exam with a fibrillar pattern then one must biopsy.

I thought of combining a gait analysis and static exam including shoe gear analysis and how such forces affect one’s dermatoscopic images. This topic is further discussed in the post below.

Dermatoscopes just might be useful in the OR if the sterile field is not broken

Why can’t every hospital OR be fully equipped by having dermatoscopes available to its surgeons with sterilized ice caps so as to attempt to protect the sterile field. If there is a histologic interpretation of any lesion be it inside or outside of the OR, why not consider getting a picture with a dermatoscope? This just might prove useful to the pathologist or dermatopathologist. For example a dermatoscope might be useful in distinguishing between a subungual exostosis vs an osteochondroma?The one problem I can see is maintaining sterility. The dermatoscope is not sterile. However if a sterile drape is placed over the dermatoscope and the dermlite 4 is used and the Dermlite 4 has its ice cap sterilized it just might be possible to maintain a sterile field and get a clear picture of the intraoperative area.