January 07, 2016
1 min read
Save

Ex vivo dermoscopy may target specific tissue processing, examination

Ex vivo dermoscopy recognized most vessel structures and colors when compared with in vivo dermoscopy, but may provide direction to target tissue for processing and examination, according to study results recently published in JAMA Dermatology.

Research collected 101 consecutive in vivo dermoscopy (IVD) and ex vivo dermoscopy (EVD) images of skin tumors from a private dermatology practice in Belgium between March 1, 2013 and Sept. 30, 2013. Independent scoring and comparison of the colors, structures and vessels of EVD images with the corresponding IVD images were independently scored and compared by four observers blinded to the histopathologic diagnoses.

Analysis was conducted from Jan. 1 to March 31, 2014, and included 404 observations of 101 images, including 47 melanocytic and 45 nonmelanocytic lesions. 

“The EVD image was generally similar to the corresponding IVD image but clearly darker, with the new areas of blue in 130 of 404 observations (32.2%) and white in 101 of 404 observations (42.8%) and loss of red in 283 of 404 observations (70%),” the researchers wrote.

Structures were mostly well-preserved. In the EVD images there were new structureless areas in 78 of 404 observations (19.3%) and new crystalline structures in 68 of 404 observations (16.8%).

Squames were lost in 56 observations (13.9%) in the EVD images, while crusts were lost in 43 observations (10.6%). The blood vessels in the EVD images were lost in 142 of the observations (35.1%).

“In general, most structures and colors observed on IVD can also be recognized on EVD, confirming earlier findings,” the researchers wrote. “In our study we found a general concordance of 76.8% between EVD and IVD images. The most important differences between IVD and EVD images concern the colors.”

“Ex vivo dermoscopy images … also have clear differences and the potential to improve the pathological diagnosis of skin tumors by providing direction to target tissue for processing and examination,” the researchers concluded. “Training in dermoscopy is required for the pathologist and the technical staff. More research is needed to determine the exact effect of this new method on margin evaluation and on the accuracy of diagnosis and appropriate staging of melanoma.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.