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| Method | Advantages | Limitations |
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Photography [203–205]
Total body photograph (2-D TBP 3-D TBP) Baseline photographs of individual lesions | Affordable and easy data management.
Monitoring patients with many dysplastic nevi.
Useful in the follow-up management and easy comparison for detecting change in size, shape, or color that may be suggestive of malignancy.
3D representation of the patient's entire cutaneous surface may reduce work time and clarify documentation. | Limited morphologic information. |
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Dermoscopy [8, 10, 19, 123, 206–208]
ELM (oil/slide mode and polarizing mode) | Facilitating 20–70% magnification of the skin.
Melanoma dermoscopic characteristics are well correlated to histopathologic features.
Identifying foci of melanoma for helping pathologist as to where to section the specimen so as to minimize false-negative results as a result of sampling error.
Liquid immersion provides increased illumination and resolution and sharper and less distorted colours.
Polarizing mode avoids a potential source of nosocomial infections. | Qualitative and potentially subjective.
Low magnification in routinely used instruments and the limited scope of observable structures restrict the usefulness and diagnostic applicability of the method. |
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Multispectral imaging [209–211]
Melafind
Solar scan
Spectrophotometric intracutaneous analysis | Spectral imaging is quantitative and more objective.
Less interphysician variability.
Melafind can create multispectral sequence of images in less than 3 seconds.
SIA scope can help in the diagnosis of lesions as small as 2 mm.
Analysing the location, quantity, and distribution of skin chromophores within epidermis and papillary dermis. | Difficult interpretation because of the complexity of the optical processes of scattering and absorption. |
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Laser-based enhanced diagnosis [212–214]
Confocal scanning laser microscopy
Reflectance confocal microscopy
Spectrally encoded
confocal microscopy | In vivo imaging of skin lesions at variable depths in horizontal planes and examination at a quasi-histological resolution without biopsy.
High resolution allows imaging of nuclear, cellular, and tissue architecture of the epidermis and underlying dermal structures without a biopsy and allows recognition of abnormal intraepidermal melanocytic proliferation.
No tissue damage because of low-power laser. | Processes in the reticular dermis and tumor invasion depth cannot be evaluated reliably.
Technically sensitive and expensive to use in routine clinical application.
Formal training and experience are required to become proficient in this new technique. |
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| Optical coherence tomography [215–217] | Depth of invasion can be better measured with OCT than CSLM.
Noninvasive assessment and monitor of inflammatory skin diseases. | Limited resolution does not allow a differential diagnosis between benign and malignant lesions.
Limited to thin tumors because of the strong scattering of epidermic tissue. |
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| Ultrasound imaging [218, 219] | Can provide information about perfusion patterns of lymph nodes and other soft tissues that can be used to stage the tumor. | May overestimate or underestimate tumor thickness; accuracy of results depends heavily on the skill of examiner and anatomic site of lesion. |
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| Magnetic resonance imaging [220–222] | Obtaining information on the depth and extent of the underlying tissue involvement and can be used to measure melanoma thickness or volume. | The need for sufficient resolution and adequate number of images per sequence for discriminating skin lesions. |
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