Why is epiluminescence microscopy important?

Abstract

The new morphological information provided by epiluminescence microscopy (ELM) requires a fresh approach to the analysis of pigmented lesions. It necessitates a learning process that pertains to the recognition of hitherto unknown morphological features and is based on the discrimination of these features and their combination into two different patterns. ELM has been shown to improve the sensitivity and specificity of the diagnosis of melanoma and other pigmented lesions by 25-30%. Digitized ELM (DELM) provides an unlimited capacity for data storage and retrieval. It is a computerized imaging method, objective and noninvasive; it provides objective evidence of lesional changes on follow-up; documents growth and any changes in the structure and shape of lesions; and thus helps in decisions on whether to excise them or not. It provides for quality control by means of the aforementioned documentation, which may also serve as back-up in the case of medico-legal problems. In addition, the spectrum is widened by the dimension of teledermatology and cybernet computer-assisted diagnosis, which holds great promise for the future. ELM and DELM are thus the most important single development of the past three decades in the early diagnosis of melanoma.