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 clin ical assessment of cutaneous pigmented lesions. Diagnostic patterns we re described to provide guidelines for the preoperative diagnosis of p igmented 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 prev iously described in cutaneous pigmented lesions. Methods: A fiber-opti c camera, allowing magnification up to 400 times and associated with a n 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, i s 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 l ines of its grids. The ''on-the-grid'' type was smaller than the ''in- the-hole'' type; it could be misinterpreted as ''black dots'' when see n at lower magnification (X 10). Conclusion: ASM is a tedious procedur e that may help in the analysis of the features previously recognized by SM; SM is more accessible for routine use.