What is epiluminescence?
The epiluminescence, synonymous with dermatoscopy, is an innovative diagnostic technique, suitable for the prior recognition of melanoma and all melanocytic skin lesions, whether pigmented or not. The epiluminescence is an absolutely non-invasive method that is performed in vivo : the analysis of skin lesions must be carried out using the optical dermatoscope, an instrument thanks to which not only the morphological structure of the condition is analyzed, but also the internal structures that constitute it.
Purpose
Effectiveness
Before proceeding with the diagnostic analysis, it is advisable to apply a contrast liquid to make the analysis possible: the contrast medium is absolutely essential in the epiluminescence, to cancel the reflected rays that would prevent the correct diagnosis.
The statistics reveal significant data for the recognition of some forms of melanoma: it seems that the epiluminescence technique increases the early diagnosis of malignant diseases in 92% of cases (against 70% of the malignant findings analyzed with the naked eye).
Applications
The epiluminescence finds application in the recognition of: basocellular carcinoma, Bowen's disease (plaque or pre-malignant papule manifested in the areas most exposed to the sun), seborrheic keratoses, actinic keratoses, dermatofibromas and other non-melanocytic tumors. Recently, dermoscopy is also useful for diagnosing the scabies mite.
To better understand the experimental mechanism on which epiluminescence is based, this technique could be compared to ultrasonography: both perform screening of the skin condition but, while ultrasound uses ultrasounds at specific wave frequencies, the epiluminescence exploits the light rays of a source (light).
Interpretation of results
Dermatoscopy is useful not only for identifying dermatological conditions: just like the double face of the coin, the expert must be able to evaluate all the aspects that derive from an accurate analysis. In fact, if the outcome determined by the epiluminescence is negative it means that a possible surgical removal is useless, since the anamnesis that derives from it is undoubted and established. Until a few years ago, when the epiluminescence techniques had not yet been completely perfected, the number of useless surgical interventions was very high: here the researchers, today, have refined the diagnostic technique in an indisputable way.
The epiluminescence was applied for the first time in the 1950s by Dr. Leon Goldman, the dermatologist who started the research and study of this particular dermatoscopic technique.
Diagnostic security
The high diagnostic accuracy of the epiluminescence, the practicality of the same, its non-invasiveness, associated with the practicality of use and the cost-effectiveness of the diagnostic method, are all characteristics that have allowed us to give dermatoscopy the primacy of recognition techniques non-invasive of dermatological diseases of varying degrees.
The analysis of skin disease by epiluminescence is called computerized morphological analysis : it represents another qualitative leap in modern research, thanks to which it is possible to study and evaluate pseudo-malignant melanoma in all its facets, in a clear and ascertained way.
The diagnostic method is so accurate that it also manages to predict any malignant implications of the neoplasm: in fact, based on the distribution of the melanin pigment and the chromatic analysis, the computerized morphological study is able to verify the progress of the lesions over time, both by evaluating past ones and by predicting the future risk of the disease itself, using samples placed in the data archive.
The epiluminescence, however, is paving the way for an evolution of diagnostic techniques: the goal is to perfect the method, in such a way as to make it objective, no longer subject to the skill and knowledge of the operator, establishing criteria morphological standards, to apply them in any skin condition.
Current studies and research on epiluminescence make it possible to draw up an increasingly safe and proven semiotics in the field of dermatology to diagnose all lesions of dermatological interest.
Key points
To fix the concepts ...
| Diagnostic technique | Epiluminescence or dermatoscopy: innovative diagnostic technique designed to recognize melanoma and all melanocytic skin lesions, pigmented or not. |
Tools used | Optical dermatoscope: analyzes the morphological structure of the disease, also identifies the internal structures, favors the recognition of possible malignant forms. The dermatoscope analyzes the skin lesion supported by an illuminated lens that radiates the part with an incident ray. |
What affections it identifies | Useful for all skin neoformations located between the epidermis and the dermis. It recognizes basal cell carcinoma, Bowen's disease, seborrheic keratosis, actinic keratosis, dermatofibrona and other non-melanocytic tumor forms. Recently, dermoscopy is also useful for diagnosing the scabies mite. |
Advantages | Painless diagnostic technique that identifies early malignant skin neoplasms. It allows to reduce / avoid unnecessary surgical interventions. |
In-depth analysis | Computerized morphological analysis through which it is possible to study and evaluate pseudo-malignant melanoma in all its facets, in a clear and ascertained way. |
Research and future studies on epiluminescence | Objective: to perfect the epiluminescence technique even more precisely, in order to establish standardized morphological criteria, without relying "only" on the expert's subjective opinion. |
