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New Approaches in the Diagnosis of Skin Cancer

 

Traditionally, the diagnosis of skin cancer relies on a physical examination (ie, with the unaided eye) and is often followed by a biopsy of suspicious lesions. Although histopathological examination is the gold standard for skin cancer diagnosis, it is still an invasive procedure associated with potential complications, such as pain, infection, bleeding, scarring, and hypo- and hyperpigmentation, among others.  Recently, many noninvasive imaging techniques have been developed to overcome the existing limitations. These techniques include optical/ light-based imaging techniques (such as dermoscopy, reflectance confocal microscopy [RCM], and optical coherence tomography [OCT]) and nonoptical imaging techniques (such as ultrasonography and magnetic resonance imaging), among others.  In this chapter, we will first review noninvasive imaging devices that are being used in daily clinical practice. Second, we will discuss imaging modalities that are being currently investigated and that we anticipate will be used in the future.  Major limitations for the widespread adaptation of noninvasive imaging devices are their cost, the learning curve for reading the images, and the lack of teaching-training programs. In the future, the use of artificial intelligence (AI) algorithms might be an aid towards global utilization and acceptance. We envision that a combination of noninvasive imaging aided by AI diagnosis has the potential to create a major paradigm shift in dermatology practice and patient care.   

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