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Dermatology

The Use of Dermoscopy in Italy: How the Dermatology Camera DZ-D100 Is Helping to Reduce Workload in Clinical Settings

Associate Professor Enzo Errichetti (Italy)

The Mediterranean country of Italy has a high incidence of skin cancer, partly due to the national fondness for sunbathing that Italy shares with other European countries. Many dermatologists actively incorporate dermoscopy, which involves using magnifying glasses to examine skin conditions in detail. Associate Professor Enzo Errichetti is one of them. We interviewed Dr. Errichetti, who is a devoted user of the Casio Dermatology Camera DZ-D100 (hereafter, Dermatology Camera) and Dermatology Scope DZ-S50 (hereafter, Dermatology Scope), about the state of dermatology in Italy and his experience with Casio products.

Italian Dermatologists Have a Tradition of Emphasizing Detailed Clinical Observation of Lesions

—Dr. Errichetti, you are one of the most reputable dermatologists in Europe. What dermatological organizations are you usually active in?

Dr. Errichetti: “I work as a senior dermatology consultant at the Ospedale S. Maria della Misericordia, a university hospital in Udine, Italy, and I’m qualified as a professor of dermatology at the national level. I’m also the secretary general of the Italian Association for Non-Invasive Diagnosis in Dermatology.

I serve on the board of directors of the International Dermoscopy Society (IDS) and chair its task force on Imaging in Skin of Color. My specialties are dermoscopy of inflammatory skin diseases and research on skin color. I’ve authored around 200 medical publications. I consider my work to be multi-missional.”

—Italy was an early adopter of dermoscopy for skin disease diagnosis. What was behind this?

Dr. Errichetti: “In Italy, dermoscopy is considered very traditional, and many doctors approach it with passion. This is because Italian dermatologists have been analyzing the details of skin lesions and tumors even before the advent of dermoscopy. This history dates back to the days when examinations were done with the naked eye without any instruments. Now, dermoscopy has acquired an important role in skin examinations. However, even before this, there were already many doctors who were interested in observing and studying the color and shape of lesions from a clinical perspective. This provided fertile ground for adopting and developing the new technology of dermoscopy. This has become a unique characteristic of Italian dermatology from an international perspective.”

—Are there any challenges Italian dermatologists face in their research and daily activities?

Dr. Errichetti: “The biggest problem is the shortage of doctors. Large public hospitals have many tasks to perform but not enough doctors, leaving little time for both clinical practice and research. The salaries aren’t very high, so it’s not a popular field. Some doctors work two jobs, preferring to work in private practice rather than public hospitals.

The government and public organizations provide financial support for purchasing medical equipment, and I believe introducing Dermatology Cameras will improve efficiency and make it easier to manage time. However, it’s difficult to completely compensate for the absolute shortage of doctors.”

User-Friendly Operation and the Convenience of Capturing Three Types of Images in One Shot

—How many patients do you see in a day in your clinical practice? And what proportion of patients do you examine with the Dermatology Scope?

Dr. Errichetti: “I see about 25 to 30 patients a day, or about 80 to 100 patients a week. The time I can spend with each patient is, at most, 15 to 20 minutes. It’s not really possible to spend a lot of time with one patient.

I use the Dermatology Scope on basically all patients. To avoid missing important conditions, I properly examine even nail diseases and moles with the Dermatology Scope.

There’s no characteristic difference in the number of patients by age or gender, and I sometimes see elderly patients over 80 years old. About half of the patients come to our hospital for mole mapping, and in many cases, they come worried that their mole might be a malignant tumor.”

—It seems there are many opportunities where the Dermatology Camera and Dermatology Scope could be useful. How do you usually use the Dermatology Camera and Dermatology Scope?

Dr. Errichetti: “I’m grateful that Casio has released the Dermatology Camera, which helps reduce the workload in clinical settings.

In actual use, I found it very convenient to be able to capture polarized, non-polarized, and U.V. (405nm mode) images in one shot. It is also good that not only the angle of view but also the brightness is uniform, and the edges of the images are not distorted, making them easy to view. Previously, it was time-consuming to prepare three types of images with the same angle of view in polarized, non-polarized, and U.V. (405nm mode). So the Casio product reduces shooting time, shortens consultation time, and improves operational efficiency. Personally, I often refer to U.V. (405nm mode) images during examinations. It is useful when I want to see the real size of a lesion clearly.

The captured images can be imported to a PC via Wi-Fi without hassle. The operation system is very user-friendly, and I have never had even a moment’s confusion about how to use it. The lightweight design is also a big advantage. It’s much lighter than a DSLR camera, and I can easily shoot with one hand.”

Polarized, non-polarized, and U.V. (405nm mode) images can be captured with one shutter press.

—What are your thoughts on the Dermatology Scope and the image management software D’z IMAGE Viewer D for Windows?

Dr. Errichetti: “There are many magnifying glass products on the market. Among them, the good points of the Casio Dermatology Scope are its light weight and large lens. The larger the lens, the heavier an item becomes, so this product has a good balance of usable size and weight while still making it easy to view large lesions.

I find the blood vessel enhancement function* useful when displaying captured images in the PC application. Doctors cannot afford to miss lesions, so we use enhancement functions like this to examine lesions thoroughly.”

*This is his impression when using the Japanese specification model.

—Do you have any suggestions or proposals for improvement regarding Casio’s devices?

Dr. Errichetti: “I’m satisfied with the completeness of the hardware. If there were a type with a larger lens, it would be possible to capture larger lesions. For the application, I hope Casio will enhance functions like blood vessel enhancement and evolve it to discern tumors and skin colors more clearly.”

—Thank you very much.

The impression from the interview with Dr. Errichetti is that he has been using the Dermatology Camera extensively. He seemed to understand points that might be difficult to notice without being familiar with the device, such as the fact that the Dermatology Camera uses a lens that is less likely to distort the center and edges of the image, allowing for images to be captured with the same color and shape as seen by the eye, and that U.V. (405nm mode) imaging makes the periphery of moles easier to see.