Review of the Illuco IDS-1100 dermatoscope with a DermLite DL4W comparison

 

Illuco IDS-1100

Introduction

The Illuco IDS-1100 is a Korean made hybrid contact/non contact dermatoscope, meaning it can switch between polarized and unpolarized light.

I purchased the dermatoscope for $724 ($504 plus $60 shipping and $150 Danish sales tax).

My regular dermatoscope is a DermLite DL4W and is $1295 in the US, and $1430 including Danish sales tax.

The IDS-1100 is comparable to the DL4W, feature wise, but the DL4 (left) has a superior build quality and is more compact.

Design

Overall the IDS-1100 feels very well built, if a bit plasticky. Focusing is easy, and toggling between polarized and unpolarized light is intuitive. There are three settings for light intensity. I prefer the medium setting, but the most intense setting may improve photography, by enabling a smaller aperture, or lower ISO, when taking pictures. I have not done such tests yet.

It is a bit annoying that the IDS remembers your last settings, because I always start by using the polarized light. The DL4 defaults to using polarized light, when you turn it on, and you cannot adjust the light intensity. I prefer this, "keep it simple" design.

The IDS-1100 is big, there are no two ways about it, and even though the contact plate is larger, the useful field of view is about the same as on the DL4.

Most of the time, the large size is not an issue, but it can make it more difficult to examine sites such as interdigital spaces.
Special contact plates for nails are available, but not included.

Looking at the LEDs, without the contact plate, shows how much space is taken up by the light source, and focusing mechanism. The contact plate is held magnetically. There has been some talk of that being a risk when examining patients with pacemakers, but the actual physics make that highly unlikely. The contact plate on the DL4W snaps on instead of using magnets.

You may notice that the DermLite seems to use identical LEDs, for polarized and non polarized dermoscopy, but with polarization filters over the LEDs used for polarized dermoscopy, whereas the IDS-1100 uses polarized and unpolarized LEDs.

Polarized and unpolarized modes on the IDS-1100

Polarized and unpolarized modes on the DL4W

The light from the DL4W (left) is warmer and more natural, whereas the light from the IDS-1100 (right) is more cold. I don't think this makes much of a clinical difference, but I find the DL4W more pleasing.

In the box

The IDS-1100 comes with a pouch, a good quality USB to Micro-USB charging cable, some alcohol whipes and a piece of cloth. No charger is included.

Accessories

Check out Illuco's website for all the options: https://illuco.co.kr/Dermatoscope_IDS-1100

I purchased a universal adapter ($60), but adapters exist for most iPhones and Samsung Galaxy Phones.

Personally I prefer using a cover-adapter for for a smartphone, and I use one for a Samsung Galaxy S8, with my DL4 in my office.

The S8 has a great camera and is now very cheap to purchase used, so I don't have to use my personal phone.

 

The Illuco Universal adapter is fine, but it drifts easily, so you may need to adjust it between use.

Fortunately I found that the IDS-1100 is compatible with DermLite's adapters, but the DL4 is NOT compatible with the Illuco adapter though.

The magnetic ring on the DermLite adapter is a little bit bigger than the Illuco, but it holds the IDS-1100 strongly, and is easy to center.

The original adapter fits more snugly, but cannot hold a DermLite.

The DermLite Universal Adapter works better than the original one IMO

When using the DermLite adapter, the dermatoscope can slide a little bit, but I don't feel that is a real issue.

DermLite makes a lot of great adapters, like this one for a Samsung Galaxy S8. It being compatible with the Illuco is practical if you were to use both brands.

Like with the DL4W, and other DermLites, the magnetic attachment is very strong and practical.

Conclusion

There is no doubt that the DermLite DL4W is the better dermatoscope, but at almost half the price, you really can't go wrong with the IDS.

Pros

Cheap compared to the competition

Good optical and built quality

Polarized and unpolarized modes

Contact and non contact capable

Multiple adapters and accessories

Compatible with DermLite adapters, but use at your own risk

Charges via USB (micro-USB)

Cons

Much larger than the DL4, without any real benefit

Light is a bit cold and unnatural

Does not use USB-C

Fjernelse af ørevoks, nye gadgets!

I et forsøg på at få tips til at fjerne ørevoks ifm. otsokopi af små børn, faldt jeg forleden over denne side: http://www.utmb.edu/pedi_ed/aom-otitis/equipment.htm
Det fremgår der, at en ørelæge primært anvender briller med forstørrelse, pandelampe og små plastikcuretter til at fjerene ørevoks, og det på ca. hver 5. patient.

Brillerne var simpelthen et scoop. Købte den fra Kina på Ebay til 300kr. Der kom så import-afgift/told for 250kr oveni.

Der er 3,5X forstørrelse og et super lys. Det er selvfølgelig noget plastikskrammel, men optisk og lysmæssigt er de alletiders, sidder godt på hovedet og bliver en kæmpe hjælp når jeg næste gang skal fjerne ørevoks på en etårig med AOM eller små sutturer efter en øjenlågsoperation.

Det lykkedes mig at finde en forhandler af Bionix-curetterne: http://www.pcwerth.co.uk/
De koster ca. 5kr pr. stk, men jeg tror sagtens de kan vaskes og genbruges.
Har købt disse:

http://www.pcwerthstore.co.uk/products/Bionix-Articulating-Safe-Ear-Curette-%252d-5%252dpack.html

http://www.pcwerthstore.co.uk/products/Bionix-Safe-Curettes-%252d-Variety-Pack-of-75-single-use.html

http://www.pcwerthstore.co.uk/products/Bionix-Safe-Curette-%252d-InfantScoop-%252d-5%252dpack.html

Nu venter jeg bare på den første patient med et ørevoksrelateret problem :-)

Monitor til praksis

Jeg har brugt en del tid på at finde egnede skærme til praksis.

Er endt med at købe Dell ultrasharp u2412m 24 tommer skærme. De har matte 16:10 IPS-paneler, kan justeres på alle måder, er pæne/enkle, har super pænt neutralt billede og så er de billige (Ca. 1900,-).

En anden god, og helt tilsvarende skærm er
Lenovo Thinkvision L2452p som koster næsten det samme.

http://reviews.cnet.com/lcd-monitors/dell-ultrasharp-u2412m/4505-3174_7-35002356.html

http://computers.toptenreviews.com/monitors/lenovo/lenovo-thinkvision-review.html

Dermlite DL3 Dermatoscope, review in progress.

I'm going to write this up in English, as there are few available online reviews of dermatoscopes.

Introduction:
I have been using a Welch Allyn Episcope for some time now, but wanted to be able to take photos of lesions, which, in some instances, would enable me to send images to a specialist instead of referring the patient or removing a possibly benign lesion.
The choice came down to the either the Heine Delta 20 or one of Dermlite's options.
The DL3 appealed to me because it could do both cross-polarized and non-polarized dermoscopy.



I already owned a mirrorless interchangeable-lens camera (Olympus E-P1), but it had an older version of the kit-lens that had a rotating, and extending filter-adapter, rendering it useless for this because it tries to turn the whole dermatoscope when you try to focus.
I therefore bought a used, and upgraded lens.



Note the "MSC" designation and 37mm filter-adapter.
You will need to get a 37-28mm step-down ring, pictured below (got it on Ebay.co.uk for 50kr/$8)



The dermatoscope attaches easily like so:

I set a fixed focal length of 20mm, iso to 200, shutter speed to 200, and aperture to F/9.
This gives me good and sharp images using auto-focus:

The DL3 will let you switch between cross-polarized light, so that you can use it without immersion fluid and/or compression of the skin (lets you view vessels a lot better), and regular non polarized light, requiring immersion fluid. It is substantially better than my Welch Allyn in both modes, but I have not compared it to the Heine (others have though, and write that they are equally good for non polarized dermoscopy, and the Heine won't do cross-polarized).

 

The DL3 was rather expensive at 888 euro, I already owned the Welch Allyn, but I think the DL3 is substantially better, and being able to take pictures has advantages.

First of all my practice will get reimbursed for some of the expenses when we send the pictures to specialists, secondly we will be able monitor appropriate lesions by storing images, and thirdly it's a great tool for sharpening your skills, as you can look at lesions with your practice partners at the end of the day.

The ability to use cross-polarized light should not be underestimated. With it you are able to look at a lot more lesions in secession, because you don't have to reapply oil or alcohol the whole time, suddenly making it feasible to do a full body examination in a relatively short time. 

I still prefer to have the ability to use non-polarized light because some features are more visible using this mode (other features are more visible using cross-polarized).

Some notes on the choice of camera and lens:

I have chosen the E-P1 because you can get them dirt cheap on Ebay, even brand new (its 4 generations old). There is no reason to get a newer version, but the E-P2 and E-P3 can also be had pretty cheap and I think they come with the required lens standard. All the E-PX'cameras are extremely well built and easy to control. 

You can also use a lot of compact cameras, but they will require a special adapter to accommodate the 28mm filter adapter on the dermatoscope. An SLR would also be great, but I have no suitable lens for my Canon 5D.

Be aware that most lenses for interchangeable lens cameras have either a rotating filter thread or a front that moves when you focus. Be absolutely sure that you get a lens that has "internal focus".

You get a full field of view using a focal length of approximately 35-40mm on a 35mm/full frame camera. This means that on Micro Four Thirds (such as the E-P1) you will use a focal length around 18-20mm. A standard 3x zoom lens will be fine.

Using a compact such as a Canon G14 will probably give you very good pictures with good depth of field, without having to use an aperture as small as I do, but the light form the DL3 is so bright that you can just use f/9 og even smaller if you increase the ISO as you can on the E-P1.

The E-PM1 is very cheap, has the lens you need, and is easy to use for a beginner (more geared towards point and shoot than the E-P1). I got one for 1500kr ($250) brand new on Ebay. The E-PM3 can be had for around 2000kr with lens and is a great buy.

The reasons why I use this camera, are that it has good high iso performance, enabling you to take pictures without using flash, and the Olympus cameras also have good auto white balance, so the florescent light in the clinic is no problem when taking pictures of skin lesions. It turns out it's also very good for dermatoscopic photos.

Please check this page if you are interested in learning more about dermoscopy:

http://almenmedicin.blogspot.dk/p/blog-page.html

I hope you enjoyed the review. Let me know if have any questions.

Christian Tørring, August 2013



Added jan 2014:

UpToDate

Opdaterede klinikkens abonnement på UpToDate idag.
UpToDate er blevet et uvurdeligt redskab i dagligdagen og har været mit goto-opslagsværk i mere end 10 år. Desværre koster det omkring 3000,- årligt, medmindre man ikke er speciallæge endnu. Til gengæld får man det suverænt mest omfattende, velredigerede og fagligt opdaterede indhold på markedet.
Jeg er naturligvist biased af at have brugt værket i så mange år, men stort set alle jeg har introduceret det for er blevet brugere.
Der er en kæmpe værdi i at have et opslagsværk som er så omfattende, fordi man næsten aldrig søger forgæves. Indholdets omfang er ekstremt klinisk orienteret med referencer og abstracts, hvor det er relevant.
UpToDate er udelukkende finansieret af abonnenter. Der går sjældent en dag hvor jeg ikke slår noget op, og det oftest med patienten ved siden af. Det er så nemt at søge og finde den ønskede informationen, at det sagtens kan lade sig gøre.

http://www.uptodate.com

Jeg prøvede i en kort periode at sammenligne opslag i UTD (uptodate.com) og NEL (https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/), men kom ikke rigtig videre med det. Mine rå data, lægger jeg ved nedenfor.
Grundlæggende af lægehåndbogen jo blevet et godt redskab, men er efter min mening for overfladisk og jeg føler mig endnu ikke overbevist om at den opdateres hyppigt nok. Til gengæld er den hurtigt på vej til at været tilpasset danske forhold og de fleste problemstillinger er ved at være dækket, så mange er nok tilfredse med det.
Jeg bruger UpToDate primært, så jeg er biased, men indholdsmæssigt er der ingen sammenligning.
For en almenmediciner vil jeg mene at man er godt dækket ind med en dermatologi-bog, UpToDate og evt. et abn. på Medibox.

Opslag under arbejdsdag:

2010:
7/12:
Google: Børne-væskevandladningsskema. 5 årig med enuresis. < 1 min.
NEL: Phimosis 2 årig, prevalenser + patientvejledning. < 1 min.
UTD: Analfissur. Behandlingsregime. < 1 min.

8/12:
UTD: Mortons neurom. Forfodssmerter. < 1 min.
Ditto NEL: < 1 min mere omfattende.

14/12:
UTD influenzavacc. barn dosis <1 min
UTD vaginit og gruppe B streptokokker <1min, men ingen informationer, samme for NEL
Pubmed fundet artikkel med relevant svar på ca. 2 min.

15/12:
UTD UVI børn diagnositisk strategi < 1 min (NEL lidt mangelfuld ift. hvornår diagnosen bør forfølges)

16/12:
UTD: Skoldkopper exponering af gravid med ukendt immunitetsstatus. Svar ca. 3 min søgning og læsning. Grundig information.
NEL: Ingen hjælp at hente.

17/12:
Skulder impingement, undersøgelsesteknik/diagnose: NEL 2min, intet svar fundet. UTD: < 1
Prævalens af helicobacter pylori infektion (hypighed 30 årige), UTD: < 1min.

2011:

22/1:
UTD: Superficiel thrombophlebit, udredning < 2 min.

24/1:
NEL: Funduplicatio-pt.vejledning < 1 min.
UTD: Enterobiasis, livscyclus orm, efter pt. spørgsmål. < 2 min.
UTD: Hypercalcæmi, udredning < 2min.
UTD: Pyrophosfatartrit, generel gennemgang < 5min.

31/1:
UTD: Depo-provera-behandling. Bivirkninger og effekt. < 2 min
UTD D-vitamin metabolisme, vurdering af depoter/serum-værdier < 1min

1/2:
UTD: Whiplash/Akutte nakkesmerterter, behandling. <3 min

NEL: Ditto+god pt.vejledning. Lidt mere overfladisk og firkantet i gennemgangen og ikke så meget hjælp til den vanskellige pt., men velskrevet og overskuelig. < 2min.

Dermoskopi

Jeg har dermoskoperet de sidste 3 år, dog uden nogen træning, nok mest fordi det involverede et nyt gadget og virkede professionelt.
Når jeg så noget mærkeligt, sendte jeg det videre. Har ikke fjernet mere end et par pigmenterede nævi siden jeg startede og har nok henvist langt mere end jeg burde.
Jeg har nu brugt en del af min ferie på at sætte mig bedre ind i teorien og glæder mig til at komme igang næste uge, hvor mit NYE dermoskop venter på klinikken!
Har købt et Dermlite DL3 som kan bruges både med polariseret og ikke-polariseret lys, og har adapter til klinikkens kamera så vi kan gemme billeder og sende til dermatolog.

Jeg har samlet en bunke links til de interesserede. Det er et fascinerende emne med stort potentiale for brug i almen praksis:

Video Podcast: http://www.dermatoscopie.org/en/videos_result.asp

Video Course: http://www.dermlite.com/cms/en/learn/for-professionals/video-course.html

Video Course: http://dermoscopymadesimple.blogspot.dk/p/video-teaching.html

Web-guide: http://www.danderm-pdv.is.kkh.dk/derma/section1/index1.html

Web-guide: http://dermoscopymadesimple.blogspot.dk/

Quiz og atlas: http://danderm.dk/derma/index.html

international dermoscopic society: http://www.dermoscopy-ids.org/

Dermatoskoper: http://www.dermlite.com/

Atlas (dyrt, men det bedste): http://www.amazon.co.uk/An-Atlas-Dermoscopy-Ashfaq-Marghoob/dp/0415458951/ref=sr_1_3?ie=UTF8&qid=1374473805&sr=8-3&keywords=dermoscopy

God lærebog 1: http://www.amazon.co.uk/Dermoscopy-Essentials-Expert-Consult-Online/dp/0723435928/ref=pd_bxgy_b_img_y

God lærebog 2: http://www.amazon.co.uk/Diagnostic-Dermoscopy-The-Illustrated-Guide/dp/1405198559/ref=sr_1_1?ie=UTF8&qid=1374473805&sr=8-1&keywords=dermoscopy

LEO udgiver også en god bog af Kaare Weismand, Henrik F. Lorentzen og Carsten Sand: Dermoscopy

Blog 1: http://dermoscopic.blogspot.dk/

Blog 2: http://dermoscopy.wordpress.com/

Artikel om brug i praksis: http://www.mims.co.uk/news/918898

Guide og limks til kurser i England: http://www.pcds.org.uk/p/dermoscopy-purpose-of-dermoscopy-in-primary-care

Dermlite DL3 dermokop: Praksisdienst

Dermlite DL3 kan både udføre både polariseret og ikke-polariseret dermoskopi og kan sluttes til kamera via 28mm filter-gevind.

Køb stepdown adapter til kamera xx-28mm og sørg for at opjektivet har intern fokus så fronten ikke roterer eller bevæger sig ifm. fokus. Olympus's MFT kameraer har oftest dette og er meget billige brugt.

Det mest populære dermoskop er nok Heines Delta20, men det er dyrt og kan ikke udføre polariseret dermoskopi. Welsch Allyns episcope er lækkert og OK hvis man har skafterne. Det er det jeg selv bruger, men har bestilt et Dermlite DL3. Har også 2 billige No-name dermoskoper købt på ebay, som man kan leve, eller starte ud med. De sidste koster under 1000kr, et DL3 omkring 7000,-

Første indlæg

Har oprettet bloggen mhp. at få et sted hvor jeg kan dele min passion for medicinsk teknologi og viden.
Det er IKKE meningen at der skal blogges om fagpolitik.
Alle interesserede skribenter er velkomne til at poste.