key: cord-1012830-43v36b2s authors: Jakhar, Deepak; Bhat, Yasmeen J.; Chatterjee, Manas; Keshavmurthy, Vinay; Ankad, Balachandra S.; Jha, Abhijeet K.; Jayasree, Puravoor; Save, Sushrut; Mukherjee, Samipa S.; Mehta, Hita; Udare, Satish; Beergouder, Savitha title: Dermoscopy Practice during COVID-19 Pandemic: Recommendations by SIG Dermoscopy (IADVL Academy) date: 2020-05-10 journal: Indian Dermatol Online J DOI: 10.4103/idoj.idoj_231_20 sha: 62c1178306abc2d50e66431e3e0100f872a7c543 doc_id: 1012830 cord_uid: 43v36b2s nan This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com may also serve as an important investigative tool in such times when invasive procedures like skin biopsy are best avoided. In view of COVID-19, it is only wise to avoid or postpone doing dermoscopy on COVID-19 positive cases; patients showing signs and symptoms related to COVID-19; patients with history of travel in the past 2 weeks, especially to high risk countries; patients from red zones or high risk areas; and patients with family history/close contact history of COVID-19. Dermoscopy may be better avoided wherever clinical examination is sufficient to reach a diagnosis or other modalities (with lesser risk of transmission) can be used. The importance of social distancing to minimize the transmission of COVID-19, should be kept in mind during clinical as well as dermoscopic evaluation. Wherever possible, for COVID-19 suspected patients, standardized protocol of wearing personalized protective equipments (PPE) and examination in negative pressure rooms should be followed. [9] In the coming months, after the nationwide lockdown is over, the risk of random patient with asymptomatic COVID-19 infection may still prevail, therefore we recommend certain precautions in the dermatology OPDs and clinics to be followed. It is important to make sure that dermatoscope should be wiped with 70% isopropyl alcohol wipes for at least 1 min. The dermatologist performing dermoscopy should follow all universal precautions advised by WHO [1] and wear gloves before performing dermoscopy. Patient should be advised to wear a facemask and clean the hands (with soap and water for at least 20 s or sanitization with 60-90% isopropyl alcohol). [1] Various methods have been described in literature to decrease the chances of nosocomial spread through a dermatoscope: • Disposable dermoscopic lens cover: provided with most dermatoscopes now-a-days • Plastic bottle cap: a disposable plastic bottle cap fitting the size of the dermatoscope may be used [10] • Polyvinyl chloride (PVC) food wrap: a PVC film is placed (with or without mineral oil on both sides of it) between the dermatoscope lens and the lesion [11] • Transparent adhesive tape: after placing the immersion fluid, a transparent adhesive tape is applied to assist contact dermoscopy [10] • Microscopic glass slide: a glass slide can be placed over the lesion in front of the dermatoscope [8] • Polyethylene tube for mucoscopy: a disposable polyethylene tube can be used with a USB dermatoscope for performing mucoscopy [12] • Car phone holder for oculoscopy. [13] The dermatologist while performing dermoscopy may use these methods. The lesion to be scoped should be cleaned with alcohol swabs (60-90% isopropyl alcohol) and alcohol-containing solutions should be used as interface medium. Noncontact dermoscopy is preferable over contact dermoscopy and use of a video dermatoscope or universal serial bus (USB) dermatoscope may be preferred over hand-held dermatoscope. Dermoscopy of mucosal lesions and oozy/fissured lesions is better avoided. The patient should be made to turn his head to the other side and adequate distance to be maintained so that there is minimal chance of spread through aerosol. Postdermoscopy, especially in COVID-19 suspected cases, the dermatoscope and all other surfaces exposed to the patients should be cleaned with 60-90% isopropyl alcohol. It is advisable to clean the mobile phone, if used for the visualization of the images using the dermatoscope. As a paperless approach is better, a digital dermoscopy report is preferable. All materials used for dermoscopic examination should be disposed as per biomedical waste guidelines. Nil. There are no conflicts of interest. World Health Organization. Critical preparedness, readiness and response actions for COVID-19-7 Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1 Dermatology staff participate in fight against Covid-19 in China What are we doing in the dermatology outpatient department amidst the raging of 2019-nCoV? Cutaneous manifestation in COVID-19: A first perspective Dermatology practices as vectors for COVID-19 transmission: Acall for immediate cessation of non-emergent dermatology visits Prevention of possible cross-infection among patients by dermoscopy: Abrief review of the literature and our suggestion Initiation of a new infection control system for the COVID-19 outbreak Preventing cross-infection during polarized dermoscopy using hand held dermatoscope Virologic safety of polyvinyl chloride film in dermoscopic analysis of mucosal areas Innovative modification of the USB dermatoscope for mucoscopy Using a car phone holder for performing oculoscopy with auniversal serial bus dermatoscope