Using the Microscope in a Dermatology Clinic
Dermatology is the branch of medicine that deals with the skin and skin diseases. This includes not only cosmetic concerns but also the treatment of skin lesions and even the performance of cryosurgery to treat warts and skin cancer. To assist the dermatologist in examining the patient’s skin and diagnosing possible diseases, the use of instruments such as the low power stereoscopic dermatology microscope is quite important. Then, the sample specimens would be looked at under a glass slide using the high power biological clinical microscope. These are clearly two different types of optical instruments. The stereoscope instrument is often mounted on a large stand frame and capable of being moved over the patient to view different areas of the skin. The high power version is a clinical lab bench model used for looking at the specimens taken from the patient’s skin.
There are parasites or skin diseases that can be easily seen with the naked eye, but for a thorough examination of the patient’s skin and hair, the dermatologist might require the use of a clinical dermatological microscope.
In a microscope-assisted dermatological examination, the dermatologist would begin with taking samples of the skin going to be examined under the compound microscope instrument. This is for the detection of such fungus as the dermatophyte, which is a parasitic kind of fungi that may cause infection on the patient’s skin, hair or nails. This fungus is responsible for such skin conditions like athlete’s foot and skin ringworms.
To begin with the examination, the skin or hair sample would be mounted on a microscope slide. Liquid paraffin would usually be added to improve the image being seen through the ocular of the biological light microscope. Some dermatologists actually prefer to use potassium hydroxide (KOH) in mounting the slide since it clears away the keratin in the sample and makes it easier for the dermatologist to see the hyphae and the spores of the dermatophyte with that kind of solution. On the other hand, it is also hard to detect the fungus even using a compound light microscope, which requires the dermatologist to examine the sample again.
A prepared microscope slide with the skin or hair sample from the patient would usually be mounted in liquid paraffin or KOH as already mentioned above. Very seldom do the oil-immersion objective used in viewing dermatological samples. For example, setting the magnification at a low-power objective would already allow the dermatologist a thorough examination of the patient’s hair and even the parasites that could be found on both the patient’s skin and hair. A higher power objective would be used for the identification of parasites and the detection of dermatophyte.
Because the clinical microscope allows a two-dimensional image of the sample being viewed under the microscope lens, skin or hair samples should also be flattened before the dermatologist can put on the slide cover on the glass slide. This would help reduce the blurring that can result from the contours of the sample itself, keeping the specimen within the focal plane of the optics.
Based on their findings using instruments like the dermatological microscope, necessary treatment would then be recommended by the dermatologist to the patient. Dermatophytes, for example, can be treated with the application of ointments.
On another hand, it might be necessary for the dermatologist to view the different layers of epidermal cells in the patient. This can be done without actual penetration into the skin by using confocal laser scanning microscopy (CLSM). CLSM allows the dermatologist to see an optical sectioning of the skin being viewed under the microscope lens due to its ability to produce high resolution images of thick specimens, which would be in this case, the skin of a patient.
This technique entails the use of high-power microscope that would allow the dermatologist accurate measurements of surface and subsurface microstructures of the skin, which would help not only in the diagnosing of skin diseases but also in dermatological research.
A biological light microscope is quite useful in the field of dermatology. Acquiring a good and sturdy clinical microscope and other dermatology instruments is essential to those in the practice.
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