Epiluminescence: what it is and what it is used for

By Cristiano Antonino On Jan 18, 2023

Epiluminescence, or dermoscopy, is an innovative diagnostic method that makes it possible to study – through a microscope – suspicious skin formations and check whether they are malignant at an early stage

How epiluminescence works

Unlike simple observation with the naked eye or with a magnifying glass, which only allows the external appearance of a skin spot (morphology, colour and type of border) to be appreciated, epiluminescence allows the internal structures that characterise the lesion to be observed.

Using a contact microscope (the dermatoscope) connected to a light source, the dermatologist can visualise the anatomical micro-structures of a skin neoformation, located between the epidermis and the dermis.

This direct assessment, in an absolutely non-invasive and painless manner, will make it possible to identify the suspicious features of melanocytic lesions, i.e. correlated to specific histological alterations.

How is epiluminescence performed?

Epiluminescence microscopy can be performed either with a microscope for direct observation of the skin, or using a camera with variable magnification, connected to a monitor for a digitised view of the skin lesion.

The instrument is placed on the skin, after application of a contrast medium (a liquid), and will return the most microscopic features of moles, lesions, keratoses, epitheliomas.

Thanks to dedicated software, it will be possible to carry out a screening of moles or other neoformations and, if the dermatologist deems it appropriate, also the mapping of atypical ones to monitor their evolution over time.

Epiluminescence, if performed correctly, greatly increases the capacity for early detection of melanoma compared to observation alone, as well as reducing the number of unnecessary surgical removals due to its high diagnostic accuracy.

When to do epiluminescence?

The epiluminescence mole test is a check-up indicated by the dermatologist based on the specific characteristics and risk factors of each patient.

In general, it is recommended

in the presence of a large number of moles
when a change in the shape, colour or size of a mole is noticed;
if there is a family history of melanoma;
in the event of prolonged exposure to the sun or following sunburn;
when the person has special skin characteristics such as a very fair complexion and is therefore more exposed to the risks of skin cancer.