In recent years the incidence of malignant melanoma has risen sharply in the UK to 10 new cases per 100,000 population per year.
There are approximately 1,500 deaths from malignant melanoma in England and Wales each year. Many of these are in the 15-39 year-old age group, making melanoma a significant cause of cancer in the young. Deaths at a young age also mean that the life years lost from melanoma are very high.
DermLite Lumio Skin Examination Device
One of the problems with malignant melanoma is that excision is the only reliable treatment, with no chemotherapy or radiotherapy available. It is now widely agreed that the Breslow thickness of the melanoma is the most significant prognostic factor. Hence, the earlier melanomas are detected and removed, the higher the five-year survival and the less likely a terminal prognosis.
When presented with pigmented lesions, it is important to determine which ones need excision and which ones can be left. The ABCD rule and the seven-point checklist help, but clear visualisation of the lesions remains very important.
In the surgery, we are often presented with a large number of moles over a patient's body which we are expected to assess in the few minutes we have for an average appointment.
This is where the Dermlite Lumio is very helpful. At an impressive 29cm in length, with a 75mm diameter lens and 40 LEDs it is enough to make Sherlock Holmes jealous.
Unlike the more familiar dermatoscopes, the Lumio has a two-times magnification compared to their 10-times magnification. This does not reveal dermoscopic features as well, but has the big advantage that a much larger area of skin can be inspected in a shorter period of time.
The Lumio gives a crisp, clear, glare-free image of the area viewed thanks to its permanent cross polarisation. For those who have never viewed skin with the polarised device, it can be best described as looking into the skin as opposed to merely looking at the skin.
The Lumio is powered by 4 AA batteries which add to the weight giving it a sturdy and ergonomic feel. Shaped like a formal magnifying glass, it sits comfortably in the hand and can be moved over the skin with ease.
With my eyes (which aren't perfect), it focused at 100mm from the surface of the skin. Like other DermLites it requires no gel or contact with the skin surface. The 40 bright white LEDs provided amazing illumination and apparently the 4 batteries allow 250, 30-second examinations.
The batteries are not rechargeable but lithium-ion, alkaline or nickel-metal hydride batteries can all be safely used. There is an orange low battery indicator light and the batteries can be changed by sliding open a compartment in the handle.
Although not as portable as other DermLite dermatoscopes, the Lumio is provided with a sturdy neoprene pouch with a zip closure. It also comes with a five-year warranty.
Overall, I was very impressed. My consulting rooms tend to be dark and inspecting multiple moles individually with a normal dermatoscope can be time consuming. This device allowed an accurate sweep of a large area of skin with significantly better detection of skin lesion features compared with the naked eye. It was also ideal for day-to-day visualisation of other conditions such as leg ulcers, varicose veins and head lice.
Dr Stollery is a GP in Kibworth, Leicestershire and a clinical assistant in dermatology at Leicester Royal Infirmary
Equipment supplied by Williams Medical Supplies.