I do not use this dermatoscope that much because I do not like the magnification. However if one has a toenail lesion one could tape on a samsung phone and use the phone to enlarge the image. The image is nonpolarized light so one would need to use some sort of clear ultrasound gel to be applied to the toenail. These are my personal opinions.
Can viscous immersion fluid using ultrasound gel be used with the firefly dermatoscope?
The ridge pattern in whites is great for telling if a lesion is malignant 98% of the time. But in black skin the benign macules often have a dark pattern. Thus I am guessing that if a ridge pattern is present in dark skin one does not necessarily have to biopsy. I am guessing that a dark skin person might show a lattice pattern with a fibrillar pattern and even if it is a ridge pattern it is benign and one does not have to biopsy. I am further guessing that if the lesion is less than .7cm one does not have to biopsy. This all has to do with volar regions on the bottom of the feet. I am also guessing that on the bottom of the feet if the lesion or color is not uniformly distributed or the pattern is really nonuniform one should biopsy even if smaller than .7cm.
It is so important to understand when not to biopsy. This is one reason why podiatrists would benefit from joining the American Society of foot and Ankle Dermatology. At their seminar I asked one of the speakers what is a contraindication to a punch biopsy. As a part of the history one could ask are their any color changes or any temperature sensitivity and if not then document no allodynia and proceed with the punch biopsy. It is more difficult in the case where there are color changes or temperature sensitivity. In this case my suggestion is to document the patient understands the risks of RSDS or CRPS and to only proceed with the punch after a full dermatologic history regarding skin cancer or family history of skin cancer and after the use of a dermatoscope combined with a clinical exam.
I never used the dermatoscopes below. Does anyone have any experience with the dermatoscopes below?
I am guessing that the features of the dermlight 3 and dermlight 4 are very close. Since I have the dermlight 4. I can begin posting my thoughts about its strong polarization and clear image and ability to toggle at the push of a button from the polarized and nonpolarized views. This is ideal for me. Once I get the clear image into the chart I have the option of using the Firefly to show the patient the image on my laptop computer. I did have a problem that the windows 10 anniversery update so I had to roll back my laptop to windows 8 to use the firefly to show such an image.
disclaimer: I am an amazon associate and if you purchase any of the products listed by amazon by clicking the link I get paid a commission.You may not know this but Amazon pays a commission to people for advertising their products. I am guessing the commission is about
4 percent of the sale.
I used the wired firefly dermatoscope. The magnification is quite good and there is the advantage of having the patient see the image on a pc computer.
There are advantages to using the wired firefly dermatoscope compared to the wireless firefly. Not only is it less expensive, the resolution I believe is better. I have been able to show patients on a computer screen the images.
However my personal opinion is that I appreciate the polarization feature on the Dermlight 4 to be better for me. I more clearly see structures using the Dermlight 4 especially on the nonvolar parts of the foot. Please shop around. The prices listed on the links just might not be the lowest prices. Perhaps e-bay has lower prices.
Again, you may think that the firefly that is wireless is better. I am guessing the wireless firefly dermatoscope may not have the as good a resolution and costs more than the wired firefly which attached into the usb hub of a computer. .
These are my personal opinions and are not to be used for any type of medical advice.
First you have to focus
I am guessing that milia cysts and superficial lesions are
best seen using the firefly by using a contact plate and turning the polarization ring to 15 degrees or 45 degrees. The one disadvantage of thecontact plate that attached to the extender is that there is light distraction from the periphery and the lights are reflected into the view on the periphery. If one does not use the contact plate it is difficult to see milia cysts.
Also when using the contact plate if one rotates the polarization ring to zero degrees or 90 degrees on glaborous skin one can see the wider ridges have those eccrine ducts. However if one rotates to 15 degrees or 45 degrees then one has difficulty seeing the eccrine ducts.
WARNING DO NOT APPLY FLUID OR HAND SANITIZER GEL ANYWHERE
EXCEPT TO THE OUTSIDE OF THE EXTENDER CAP AND CAREFUL NOT TO
LET ANY FLUID DRIP INTO THE FIREFLY LIGHTING UNIT. THIS JUST MIGHT CAUSE HARM TO THE UNIT.
THE DERMLIGHT 4 HAS A BUTTON THAT ALLOWS ONE TO TOGGLE BETWEEN POLARIZED AND NONPOLARIZED VIEWS AND THIS IS SO MUCH EASIER FOR ME TO USE THAN THE POLARIZATION RING ON THE FIREFLY. I BELIEVE THE POLARIZATION ON THE DERMLIGHT 4 IS SO POWERFUL.
Disclaimer: No post at this website or blog is considered to be any type of medical advice. It is only posting personal opinions.
Also I am an amazon associate and if you click any of the links and purchase the products I get paid a commission I am guessing of
about 4% of the sale.
I already have another book called Dermoscopy The Essentials yet I feel that I wanted to order Dr. Marghoob’s book after hearing him speak.
E bay or another site might have this book for a cheaper price so shop around.
Did anyone ever see a symmetrical lesion with a negative network with curvilinear brown structures and hypopigmentation next to them?
I learned that it must be biopsied. Do benign lesions have the above
appearance. It is so difficult to tell.
Next question what about amelanotic cancers with shiny white structures
vessels or ulcerations? Well during that lecture I learned that when one used polarized light vs non polarized light the clearness of the vessels
changed. Thus perhaps changing the polarization of a dermatoscope may
Bottom line is a comprehensive text is needed.
I learned from the lecture I attended and I am still awaiting the textbook that I ordered.
What other society is so dedicated and informative? Please visit http://www.dermfoot.com
and consider joining.
The lectures teach one when not to biopsy, when to biopsy, etc… and so much more. What a wealth of knowledge.
I believe this society in dedicating itself to educating others enables our patients to better be enabled to
examine, diagnose and treat dermatologic conditions of the feet.
Examining a skin lesion on the foot can be difficult without a dermatoscope.
There are different types of dermatoscopes. I used
the firefly dermatoscope and I am used to it.
My comments on the Dermlite 4 are not yet complete:
So far my thoughts on the Dermlite 4 is it has such an increased polarization that is needed of the increased polarization that is so needed to clearly see structures especially on the non volar parts of the feet.
It also has a pigment boost as well as the ability to toggle between the polarized and non polarized views by pushing a button.
I will be adding my thoughts regarding the Dermlite 4’s pigment boost.
So far, I am very pleased with the features on the Dermlite 4 compared to what I was using before.
Some definitions and words in Dermoscopy may be new to all those that do not currently use such instrumentation:
Please go online and look up the word Dermatoglyphics. You probably will conclude the plantar aspect of the feet have dermatoglyphics or ridges present. I like to refer to the plantar skin that consists of skin without ridges and skin with ridges.
The article in Podiatry Today regarding Acral Lentiginous Melanoma referred to the plantar skin I believe as consisting of ridges and furrows.
This is discussed in many online sites. I think of a fingerprint on the hand or a foot print. Fingerprints have ridges which follow a certain pattern. The plantar ( or acral ) surfaces of the feet have ridges.
Please go online and look up the word Dermatoglyphics. You probably will conclude the plantar aspect of the feet have dermatoglyphics or ridges present.
What is Wallace’s line
At a certain level on the foot the dermatoglyphics begin to stop. This is called Wallace’s Line. This I learned at the Derm Foot Seminar. This is one reason why I am advocating that podiatrists go to the Derm Foot Seminar and the they consider purchasing the Atlas of Dermoscopy mentioned earlier.
Proximal to Wallace’s line one can the 3 point check list that emphasizes if a lesion is asymmetric, has an atypical network, or has blue white structures. Dermoscopy the Essentials explains this quite clearly.
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My practice is limited to only treating the foot.