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Brief Report
October 2018

Assessment of the Safety Risk of Dermatoscope Magnets in Patients With Cardiovascular Implanted Electronic Devices

Author Affiliations
  • 1Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
  • 2Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
  • 3Department of Dermatology, University of Zurich, Zurich, Switzerland
  • 4Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island
  • 5Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
  • 6National Center for Patient Safety, US Department of Veterans Affairs, Ann Arbor, Michigan
  • 7Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  • 8New York Institute of Technology College of Osteopathic Medicine, OMSIII, Old Westbury, New York, New York
  • 9Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
  • 10Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Hauppauge, New York
JAMA Dermatol. 2018;154(10):1204-1207. doi:10.1001/jamadermatol.2018.2531
Key Points

Question  Can magnets in dermatoscopes pose a safety risk to patients with cardiovascular implanted electronic devices?

Findings  In this cross-sectional study of 3 different dermatoscope models, the magnetic field measured directly above the magnets in each device was stronger than the manufacturer-recommended 5 gauss to 10 gauss threshold. However, the gauss readings at the faceplate of these devices were either substantially low or below the 5-gauss safety threshold.

Meaning  In real life, dermatoscope magnets likely present no measurable adverse outcomes in patients with cardiovascular implanted electronic devices.

Abstract

Importance  Cardiovascular implanted electronic devices (CIEDs) are susceptible to electromagnetic interference. Dermatologists regularly use devices containing magnets, including dermatoscopes and their attachments, which could pose a hazard to patients with CIEDs.

Objective  To investigate the safety risk of magnets in dermatoscopes to patients with CIEDs.

Design, Setting, and Participants  This cross-sectional observational study was conducted between January 1, 2018, and March 31, 2018, in a controlled laboratory setting. Two experiments were performed. In the first experiment (performed in the Dermatology Service at Memorial Sloan Kettering Cancer Center, New York), dermatoscopes that contain magnets were obtained from 3 manufacturers. Using a magnometer, the magnetic field strength of the dermatoscopes was measured over the magnet; at the faceplate; and at a distance of 0.5 cm, 1 cm and 15 cm away from the faceplate. In the second experiment (performed in the University Heart Center Zurich, Zurich, Switzerland), ex vivo measurements were conducted to determine how the dermatoscopes affected old-generation and new generation CIEDs (pacemakers and implantable defibrillators).

Main Outcomes and Measures  Magnetic field strength as measured directly over the dermatoscope magnet; at the faceplate; and at distances of 0.5 cm, 1 cm, and 15 cm from the faceplate. Pacemaker and defibrillator operation when exposed to dermatoscopes.

Results  After conducting 24 measurements, the magnetic field (measured in gauss [G]) strength varied between 24.26 G and 163.04 G over the dermatoscope magnet, between 2.22 G and 9.98 G at the dermatoscope faceplate, between 0.82 G and 2.4 G at a distance of 0.5 cm, and between 0.5 G and 1.04 G at a distance of 1 cm; it was 0 for all devices at a 15 cm distance. The field strength at the faceplate was found to be generally below the CIED industry standard safety threshold. None of the dermatoscopes in the ex vivo experiment exerted any demonstrable disruptions or changes to the CIEDs.

Conclusions and Relevance  In real life, dermatoscope magnets likely present no measurable safety risk to patients with CIEDs. Using the polarized noncontact mode permits dermoscopy to be performed at least 0.5 cm from the skin surface, where the magnetic field strength was well below the 5-G safety threshold.

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