Methods to reduce coronavirus disease (COVID-19) transmission risk during dermoscopy were reviewed in a letter to the editor published in the Journal of the European Academy of Dermatology & Venereology.

Previous studies suggest that severe acute respiratory syndrome coronavirus (SARS-CoV-2) can remain on door handles, mobile phones, stainless steel, and plastic surfaces for 48 to 72 hours. To prevent the nosocomial spread of COVID-19 through the dermatoscope, the authors suggested a series of protocol modifications. Prior to dermoscopy appointments, authors wrote, patients should be interviewed regarding COVID-19 symptoms and recent travel. Patients with any symptoms or relevant travel history should be discouraged from undergoing dermoscopy. Dermoscopy at certain high-risk fomite sites like the hands, nail, face, eyes, and mucosa should be avoided.

During the procedure, the authors suggested that clinicians use polyvinyl chloride food wrap, cling wrap, a disposable lens cover, a microscopic glass slide, transparent adhesive tape, or other form of barrier protection between the skin and dermatoscope lens. Intraoperative dermoscopy should be avoided, and non-contact dermoscopy should be emphasized. Prior to and immediately after the procedure, the dermatoscope should be sanitized with 70% isopropyl alcohol. All clinicians and patients should adhere to personal protective equipment guidelines. Hand washing should be performed before and after each procedure. Following dermoscopy, a paperless discharge approach is encouraged. Patients should be provided with digital reports to avoid fomite spread through office supplies. Consultation with other clinicians should be conducted electronically; preferably, just 1 clinician should be present in the examination room at any time.

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These changes in approach lessen the risk for nosocomial COVID-19 spread. “These times of COVID-19 demand a more vigilant approach in patient care than ever before,” authors wrote. “A simple change in the approach of doing common office-based procedures like dermoscopy can save the day.”

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Jakhar D, Kaur I, Kaul S. Art of performing dermoscopy during the times of coronavirus disease (COVID-19): simple change in approach can save the day! [published online March 29, 2020]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16412