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'''. |
