EPILUMINESCENCE MICROSCOPY OF SMALL PIGMENTED SKIN-LESIONS - SHORT-TERM FORMAL TRAINING IMPROVES THE DIAGNOSTIC PERFORMANCE OF DERMATOLOGISTS

Background: Epiluminescence microscopy (ELM) makes subsurface structur es of the skin accessible for in vivo examination and provides additio nal criteria for the clinical diagnosis of pigmented skin lesions (PSL s). We demonstrated that ELM increases diagnostic sensitivity in derma tologists formally trained in the use of this technique but decreases diagnostic ability in dermatologists not formally trained in its appli cation. Objective: Our purpose was to determine the effects of short f ormal ELM training on the diagnostic performance of 11 previously untr ained dermatologists. Methods: One hundred image-pairs of randomly sel ected histologically proven PSLs, photographed with (ELM) and without oil immersion (surface microscopy), were presented by slide projection to the testees. To evaluate the effects on diagnostic performance bef ore and after short-term training we used the receiver-operator charac teristics technique. Results: Without training the use of ELM did not enhance diagnostic accuracy, but rather decreased it in 8 of 11 testee s. In contrast, after 9 hours of formal training in ELM the diagnostic performance of the testees was significantly enhanced with an average gain of 8.4%. Conclusion: Our data confirm that formal training is re quired for the useful application of the ELM technique.