Comparison of visual effects of immersion fluids for dermoscopic examination of acral volar melanocytic lesions

Background: Acral volar melanocytic lesions have a high potential for malignancy. Dermoscopy is a useful, noninvasive tool for the diagnosis of such malignancies. The use of immersion fluids can provide better visual effects and improve the diagnostic accuracy of dermoscopic examinations. Methods: Fifteen volar melanocytic lesions, including two palmar and 13 plantar lesions, were included in our study. We compared the visual effects of two different immersion fluids as an interface for dermoscopy. Four combinations of immersion fluid (ultrasound jelly or mineral oil) and observation mode (polarized or nonpolarized light) were compared for visual effects during the dermoscopic examination of lesions based on air bubble inclusion and microstructure visibility. Results: Both the mineral oil and the ultrasound jelly allowed at least one microstructure to be clearly visible in each image of the acral volar melanocytic lesions examined. All modes of observation achieved acceptable visual effects. The use of mineral oil and the polarized light mode resulted in the formation of fewer bubbles than the use of mineral oil and the nonpolarized light mode (p < 0.05). The use of ultrasound jelly and the polarized light mode resulted in significantly better visual effects (p < 0.05) than that of ultrasound jelly or mineral oil and the nonpolarized light mode. Conclusion: The use of either mineral oil or ultrasound jelly as interface provides acceptable visual effects for the dermoscopic examination of acral volar melanocytic lesions. The use of the polarized light mode reduced the reflection and scattering of light, resulting in better visual effect than that achieved using the nonpolarized light mode. In the early diagnosis of acral melanoma, choosing the appropriate application of immersion fluid and observation mode yields the optimal visual effect. Copyright (C) 2013, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC. All rights reserved.