A cross-sectional study was conducted in Riyadh to determine the attitudes of dermatologists toward the dermoscopy. The convenience sampling technique was used in this study to recruit the study participants. The questionnaire tool was distributed in January 2024 through email registered at the Saudi Commission for Health Specialists.

The inclusion criterion for this study was to be a registered dermatology resident in Saudi boards in Riyadh. Any participants who did not meet this inclusion criterion was excluded from this study.

This study adapted and used a questionnaire previously tested and found valid and reliable by Forsea et al [25]. The questionnaire comprises 2 sections: the first section collected information related to participants’ demographics (gender, age, and residency level), and in the second section, the future dermatologists who participated were asked about their perspectives about the utility of dermoscopy, their use patterns, their training experiences, and their self-reported confidence in dermoscopy diagnosis.

The study protocol was reviewed and approved by the Regional and institutional human medical biological research ethics committee of Al-Imam Muhammad Ibn Saud Islamic University (approval 735/2024). Participation in the study was entirely voluntary, and informed written consent was obtained from all participants before their involvement. The study was conducted in accordance with the principles of the declaration of Helsinki. All data collected were anonymized to ensure the privacy and confidentiality of the participants.

All research data were entered into a Microsoft Excel (version 16.0) spreadsheet. Data analysis was performed using SPSS (version 28; IBM Corp). Descriptive statistics were used in the statistical analysis; relative frequencies (and percentage values) were used to present categorical variables. The chi-square test was used to assess the association between categorical variables and dermoscopy use, with a 2-sided value of P<.05 considered statistically significant.

This study aimed to assess the prevalence of dermoscopy use among dermatology residents in Riyadh, Saudi Arabia, and the need for dermoscopy training, as well as the practice’s benefits in diagnosing and treating skin diseases. The study’s sample was predominantly female. Moreover, a substantial majority of the participants were in their fourth year of residency and most of them were aged between 26 and 30 years.

This study revealed that more than half of the surveyed dermatology residents owned a dermoscope, with a considerable majority seeing a significant number of patients with cancers of all types every month. Additionally, more than half of the participants had received dermoscopy training, and a considerable proportion were pursuing academic activities provided by the residency program outside of their specialized training. The study’s findings underscore the importance of dermoscopy use and the necessity of better dermoscopy training as an invaluable tool in the earlier recognition of different dermatological diseases [25], as well as future strategic planning and enhanced dermoscopy training and practice in Saudi Arabia [26]. Our study verified that most of the participating dermatology residents used dermoscopy to manage their patients’ conditions, and they had received training on its use. A considerable proportion of the participants had used dermoscopy for 2 years, and the majority used nonpolarized immersion-contact and polarized-light dermoscopes.

These findings are consistent with those of a study conducted by Freeman et al [27] in the United States, which revealed that dermatologists apply dermoscopy in their daily routines to manage patients’ conditions and to diagnose their patients [27]. Similarly, a study conducted by Jones et al [28] on dermoscopy use as part of primary care in the United Kingdom found that dermatologists used dermoscopy to manage their patients’ conditions daily at a rate of 98.5% [28]. This study revealed that the majority of respondents used dermoscopy, with many being inspired to do so by their colleagues and mentors. However, some participants did not use dermoscopy due to the unavailability of dermoscopes in their offices and insufficient training. These findings align with those of a study by Alqahtani and AlBukhari [29] in Saudi Arabia, which identified a lack of adequate education and training among residents as a key reason for dermatologists’ reluctance to use dermoscopy. Similarly, our findings are consistent with those of a study conducted by Engasser and Warshaw [21] in the United States, which identified financial costs and lack of training as the primary reasons why dermatologists avoid using dermoscopy [30].

This study’s findings revealed that the majority of the participating dermatology residents used dermoscopy in fewer than 10% of cases involving patients with inflammatory skin lesions, in >70% of cases involving the examination of patients for pigmented skin tumors, and in <10% of cases in which patients were examined for nonpigmented skin tumors. Additionally, the majority of the participants reported that dermoscopy was useful in diagnosing melanoma, following up on melanocytic lesions, diagnosing pigmented skin tumors, and diagnosing nonpigmented skin tumors. These findings align with those of the study by Kuo et al [30], which involved dermatologists in Taiwan and noted that clinicians used dermoscopy to examine pigmented and nonpigmented lesions. This study found that the use of dermoscopy was associated with dermatologists’ increased confidence in their clinical diagnosis, that it reduced unnecessary biopsies or excisions, and that it improved record-keeping. Furthermore, the study revealed that dermoscopy use increased the number of melanomas detected compared to naked-eye examinations while also reducing the excisions of benign lesions.

This study’s demographics revealed that most of the participants were female. This preponderance can be explained by the higher proportion of female dermatologists worldwide [21,27]. In terms of age, majority of participating dermatology residents were between 26 and 30 years old. This suggests that younger dermatologists in Saudi Arabia are using dermoscopy more frequently than their older counterparts. These findings are consistent with those of a study conducted by Blum et al [31] in Germany, which reported higher dermoscopy usage rates among individuals younger than 35 years. This highlights the growing role of dermoscopy in clinical practice and the younger generation’s willingness to embrace new technologies for diagnosing and treating skin diseases.

Our results may be subject to several limitations. Despite the high response rate (87.5%), participants who chose to respond may have differed in their attitudes, experiences, or usage of dermoscopy compared to nonrespondents. As a cross-sectional study, it is limited by its inability to assess causal relationships. The sample size was relatively small, which could have increased the risk of sampling bias. Additionally, since the study was conducted in only one region, that is, Riyadh, its findings may not be generalizable to the entire country of Saudi Arabia. Furthermore, because the study involved an web-based questionnaire, it relied on respondents accurately documenting their responses, without the ability to verify their accuracy, which may have introduced bias.

Dermoscopy has been widely adopted, with more than half of the dermatology residents in Riyadh, Saudi Arabia, using this technology. Its use is increasing among dermatology residents due to its evidence-based advantages in the early detection and diagnosis of skin diseases. The participants’ ages, residency levels, and practice centers were identified as the main factors influencing dermoscopy use in Saudi Arabia. The study also highlighted a strong willingness among young dermatologists to improve their dermoscopy knowledge and skills. Based on these findings, the study recommends that policy makers prioritize funding for dermoscopy by increasing the number of dermoscopes, as well as focusing on capacity building and training for dermatology residents.