Digital Epiluminescence Microscopy in the Evaluation of Pigmented Lesions: A Brief Review

Epiluminescence microscopy (ELM) is the application of oil followed by compression by a transparent material and examination under tangential illumination with magnification. This technique reduces the reflected light from the irregular surface of the stratum corneum and makes the epidermis more transparent so that structures at the dermal epidermal junction and upper dermis may be visualized. Digital ELM is the capture of ELM images by a television camera attached to a computer. The ELM approach results in improved diagnostic accuracy for pigmented lesions in the order of 20%. Advantages of digital ELM over standard ELM are the ability to capture images in an almost endless array of colors and hues, permanence of recording without degradation over time, the ability to transmit information electronically over long distances, and the ability to enhance certain features through electronic manipulation. Among the potential applications of digital ELM are assistance in establishing the diagnosis of melanoma during screening, maintenance and retrieval of images in patients who are being followed clinically with pigmented lesions, and better understanding of clinical histopathologic correlations.