Techniques and monitoring
Epiluminescence microscopy or Dermatoscopy is a noninvasive imaging technique that significantly improves the diagnostic accuracy of melanocytic lesions and. other skin tumors.
The new computerized diagnostic systems allow to obtain total body maps, locate the lesions and electronically archive the images of the lesions with digital epiluminescence microscopy. This makes it possible to perform very precise serial checks of the patient and detect minimal changes suggestive of malignancy even when there are a large number of lesions.
A 34-year-old patient with a history of in situ melanoma in the right lumbar area and multiple suspicious melanocytic lesions.
Digital body maps of the patient: more than 150 melanocytic lesions are detected. record of 22 patient maps for follow-up. No malignant lesions are detected. Control is recommended every six months.
Follow-up at 6 months with digital body maps. Detection of a new lesion in the right specular area.
Comparisons of the patient's digital maps with negative images.
Suspect lesion of new appearance in the patient in the right specular area.
A 36-year-old pregnant patient of 4 weeks with multiple melanocytic lesions with atypia. Digital follow-up of the lesions in 6 months.
Changes in microscopy images are detected in one of the lesions on the outer side of the right thigh.
Imagen de microscopía digital de la lesión en el primer control de la paciente.
Description: Symmetric melanocytic lesion in brown structure with discrete gray blue pigmentation. Typical reticulated pattern without signs of malignancy.
Conclusion: Melanocytic lesion without signs of malignancy. Digital follow-up is recommended with the other lesions of the patient in 6 months.
Image of digital microscopy in the follow-up 6 months after the injury in the first control of the patient
Description: Melanocytic lesion that shows significant changes in its structure with appearance of hyperpigmented focus with atypical reticulum in periphery.
Conclusion: Removal and histopathological study are recommended.
Negative digital image of microscopy in the first control
Image of the second control (at 6 months)
Descripción: Lesión que presenta un área de hiperpigmentación focal con retículo atípico en la periferia. Se asocia discreto incremento de superfície.
In situ melanoma focus developed on benign melanocytic lesion (B06 / 0123).
Although any individual with pigmented skin lesions could benefit from this exploration, digital monitoring is especially indicated in patients at high risk of developing melanoma.
The most important risk factors for the development of MM are:
This technique can also be applied for the diagnosis of facial injuries, for the diagnosis of nail pigmentations and for the diagnosis of congenital nevi.
Patients with large numbers of nevi are often subjected to a large number of surgical procedures for the removal of all lesions suspected of malignancy. The improvement in the diagnostic accuracy of this technique avoids unnecessary excision, allowing an accurate diagnosis of the lesions.
Digital dermatoscopy is an exploration that must be performed in high-risk patients, usually every 6 months. It requires a minimum time per patient of 30 minutes for the taking of total body images and digital dermatoscopy.
After the study of the images obtained, a report is issued stating the existence or not of risk lesions, their location on the body map, their image of dermatoscopy and the indication or not of surgical exeresis.
This technique consists in registering digital maps of the surface of the patient's skin, in order to detect the appearance of new lesions during the controls or to detect macrocoptic changes in some element. This technique is very useful for monitoring patients with a large number of pigmented lesions.
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