Hypoluminescence microscopy of pigmented skin lesions

Since the 'renaissance' of epiluminescence microscopy (ELM), histological c orrelation of ELM structures has been the subject of many investigations, D irect correlation Is difficult because of the methodological differences be tween ELM and histopathology. In order to further understand the features o f pigmented skin lesions (PSLs), we studied whether hypoluminescence micros copy (HLM) had any advantages over ELM. Twenty pigmented skin lesions sched uled for surgical excision were chosen randomly for this study. After excis ion, the lesions were studied using standard ELM and an HLM technique. For the latter, illumination was performed from the dermal side. The HLM patter n was clearly different from that of ELM, In all lesions the 'deeper' (derm al) structures became more visible, Some structures already visible in ELM appeared more visible, particularly structures apparently localized in deep er layers of the PSL. For highly pigmented lesions the difference in the tw o approaches was striking. With the HLM technique details became visible, a nd structures which were hardly or not visible with the classic ELM approac h could be easily distinguished and evaluated. In conclusion, HLM is a simp le, easy to use, reproducible ex vivo technique that is able to provide add itional information to the conventional ELM technique. (C) 2000 Lippincott Williams & Wilkins.