title: Factors driving the use of dermoscopy in Europe: a pan-European survey.
abstract: When used correctly, dermoscopy is an essential tool for helping clinicians in the diagnosis of skin diseases and the early detection of skin cancers. Despite its proven benefits, there is a lack of data about how European dermatologists use dermoscopy in everyday practice.
  
  
  
  To identify the motivations, obstacles and modifiable factors influencing the use of dermoscopy in daily dermatology practice across Europe.
  
  
  
  All registered dermatologists in 32 European countries were invited to complete an online survey of 20 questions regarding demographic and practice characteristics, dermoscopy training and self-confidence in dermoscopic skills, patterns of dermoscopy use, reasons for not using dermoscopy and attitudes relating to dermoscopy utility.
  
  
  
  We collected 7480 valid answers, of which 89% reported use of dermoscopy. The main reasons for not using dermoscopy were lack of equipment (58% of nonusers) and lack of training (42%). Dermoscopy training during residency was reported by 41% of dermoscopy users and by 12% of nonusers (P < 0·001). Dermatologists working in public hospitals were the least likely to use dermoscopy. High use of dermoscopy across the spectrum of skin diseases was reported by 62% of dermoscopy users and was associated with dermoscopy training during residency, the use of polarized light and digital dermoscopy devices, longer dermoscopy practice, younger age and female gender.
  
  
  
  Expanding access to dermoscopy equipment, especially in public healthcare facilities and establishing dermoscopy training during dermatology residency would further enhance the substantially high dermoscopy use across European countries.
authors.affiliation: Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: A M
authors.initials: AM
authors.lastname: Forsea
authors.affiliation: Department of Dermatology, Medical University of Vienna, Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Tschandl
authors.affiliation: Dermatology Department, Universite Libre de Bruxelles, Hopital Erasme, Brussels, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Del Marmol
authors.affiliation: Department of Dermatology and Venereology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
authors.affiliation: Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia.
authors.forename: H P
authors.initials: HP
authors.lastname: Soyer
authors.affiliation: Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.
authors.forename: A C
authors.initials: AC
authors.lastname: Geller
authors.affiliation: Dermatology Unit, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D000072085:Dermatologists / Q000523:psychology; D046169:Dermoscopy / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000000981:diagnostic imaging*