Computerized evaluation of pigmented skin lesion images recorded by a videomicroscope: comparison between polarizing mode observation and oil/slide mode observation

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Abstract
Background/aims: It has now been established that ELM significantly improves the clinical diagnosis of pigmented skin lesions, particularly when associated with image analysis on digital pictures. Besides surface microscopes, so called “videomicroscopes” are nowadays commercially available. Thanks to their practicality and to their reasonable price and small volume, they could be usefully employed by general practitioners or peripheral dermatologists in their practice. The aim of our study was to evaluate the usefulness and the handiness of a videomicroscope provided with polarized light, and to compare images recorded in the polarizing mode to those of the same lesions recorded after application of oil and a glass slide. Methods: 114 images of benign pigmented skin lesions were recorded both in polarizing mode and in oil/slide mode observation. Digital images were then analyzed by means of a dedicated software, evaluating 34 different parameters. Results: The instrument is easy to handle and the acquisition of images is simple and quick. Polarizing mode observation enables the recognition of subsurface structures, like pigment network and capillaries. Red and blue components in the images tend to be more pronounced, when images are acquired by the polarizing system, whereas green components are prominent in oil images. Values referring to dark areas are also higher for oil images. However, the 2 observation modes provide digital images, whose values, in most cases, do not differ statistically. Conclusion: Videomicroscopes are cheap, space saving, and enable a quick examination of skin areas to be imaged. The possibility of a rapid switch from surface to subsurface polarizing mode observation, makes the examination procedure even faster. Our data demonstrate that polarizing mode observation and recording can be employed as a basis for clinical and computerized epiluminescence, particularly in situations, where a rapid screening of numerous patients and lesions is necessary.