AMPLIFIED SURFACE MICROSCOPY - PRELIMINARY EVALUATION OF A 400-FOLD MAGNIFICATION IN THE SURFACE MICROSCOPY OF CUTANEOUS MELANOCYTIC LESIONS

Background. Surface microscopy (SM) opened a new dimension in the clinical assessment of cutaneous pigmented lesions. Diagnostic patterns were described to provide guidelines for the preoperative diagnosis of pigmented skin lesions. Objective: Our purpose was to explore whether ''amplified'' surface microscopy (ASM), by increasing magnification up to 400-fold, provides any improvement in the analysis of patterns previously described in cutaneous pigmented lesions. Methods: A fiber-optic camera, allowing magnification up to 400 times and associated with an imaging system computer, was used for the analysis of 40 melanocytic lesions. Special emphasis was put on the most important features that can be observed in surface microscopy, the so-called pigment network and brown globules. Results: The lines (grids) of the pigment network appeared to be composed of three zones: two darker external lines and one central clearer zone. This pattern, not previously seen with SM, is compatible with the anatomy of pigment accumulation in the epidermal rete ridges. Two types of brown globules could be distinguished: one located in the center of the pigment network holes, the other on the lines of its grids. The ''on-the-grid'' type was smaller than the ''in-the-hole'' type; it could be misinterpreted as ''black dots'' when seen at lower magnification (X 10). Conclusion: ASM is a tedious procedure that may help in the analysis of the features previously recognized by SM; SM is more accessible for routine use.