EPILUMINESCENCE MICROSCOPY IN DERNIATOLOGY
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The majority of pigmented skin lesions can be diagnosed correctly on the basis of clinical criteria. However, there remains a surprisingly high number of small pigmented lesions in which it is difficult with the naked eye to make the distinction between melanocytic and non-melanocytic and benign and malignant lesions"). Epiluminescence microscopy (ELM) has been established recently as a new, non-invasive technique for the clinical diagnosis of benign and malignant melanocytic tumours, especially when the lesions are small and cannot always be diagnosed correctly with the naked eye). It represents true, non-invasive in vivo microscopy of the superficial skin layers, forming a link between the gross visual examination and histological examination03). HISTORICAL BACKGROUND ELM (also known as skin surface microscopy, incident light microscopy, auflichtmikroskopie, dermatoscopy and dermoscopy) derives from a projector in which light is shone on an object and the reflected image is projected(4.5). The term was coined by Steiner et al (1987x2.6). When they used in vivo surface microscopy in combination with oil immersion in a systemic analysis of a wide array of new morphological features that became apparent with this technique"). Correspondence: Somaia Fathy Mahmoud, M.D., 4 Nasser Khessro Street, 7th Zone, Madinat Nasr, Cairo, Egypt. In 1933 Hinselman proposed the use of colposcope for high-power examination of skin and mucosal lesionsm and Goldman in 1951's) systematically used surface microscopy as a diagnostic procedure. Then it was forgotten for almost twenty years being used almost exclusively for nail bed capillary microscopy(9-'°. Skin microscopy for pigmented skin lesions was revived in 1971 by Mackie" who invited attempts to increase the resolution of the eye in clinical diagnosis by using ELM. In 1981 Fritsch and Pechlaner improved the technique and emphasised its potential importance in the differentiation of pigmented lesions". Since then there has been considerable application of the method especially in Western Europe'''.