With dermoscopy, morphologic features are visible that cannot be detected by the naked eye alone. Therefore, dermoscopy opens up a new dimension of clinical morphology that can be regarded as the missing link between clinical morphology and histopathology. Nevertheless, when a pigmented skin tumor is excised, conventional histopathologic examination is still the standard. Dermoscopy allows visualization of the horizontal plane of a given skin lesion only to the level of the papillary dermis. Moreover, heavily pigmented skin lesions are sometimes very difficult to diagnose dermoscopically.
Amelanotic melanoma represents a particular diagnostic pitfall.
Just normal immersion oil is fine, but also alcohol and even water can be used. Most of the digital instruments work with polarized lenses and there is no need for immersion oil. In our estimation, a 10-fold magnification works well for diagnosing pigmented skin lesions. For special purposes, such as the examination of the vasculature of a given skin tumor, higher magnifications up to 50-fold may be helpful.