Direct Microscopy of Skin in Vivo as a Diagnostic Aid and Research Tool

In a large series of patients over a period of years, the new mobile and flexible stereoscopic colposcope of the gynecologist was evaluated as an aid in clinical diagnosis of cutaneous conditions. Comparisons were made with magnifiers, head loupes, and several other types of microscopes purveyed for direct microscopy of skin in vivo. The mobility of the gynecologist's instrument makes it particularly practicable for direct microscopy of many small and early lesions on the skin and mucous membranes and for capillaroscopy. Pigmented lesions of the skin, cutaneous malignancies, actinic keratoses, warts, keratoacanthomas, lesions of molluscum contagiosum, pathologic hairs, lesions caused by arthropods, and the arthropods themselves—all lend themselves to examination by direct microscopy. Training and experience are necessary for interpretation of what one sees by direct microscopy, much as one needs training and experience in interpreting what one sees in microscopy by transmitted light. Only then can the practice of direct microscopy be brought to usefulness in clinical activity, research, and education of students of dermatology.