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The Epiluminescence Microscopy (ELM) 7-Point Checklist for Evaluation of a Melanocytic Skin Lesion

Purpose: To evaluate a pigmented skin lesion using epiluminescence microscopy and the 7-point checklist of Argenziano et al.

Description

Argenziano et al developed a checklist for use during epiluminescent microscopic examination of a melanocytic skin lesion. This can help identify a lesion that has an increased risk of being a malignant melanoma. The authors are from the Universities of Naples and Florence in Italy.


 

Parameters:

(1) pigment network

(2) color

(3) vascular pattern

(4) streaks

(5) blotches

(6) dots and globules

(7) regression pattern

 

Parameter

Finding

Points

pigment network

typical

0

 

atypical

2

color

no gray-blue areas

0

 

gray-blue areas present

2

vascular pattern

typical

0

 

atypical

2

streaks

absent

0

 

present

1

blotches

absent

0

 

present

1

dots and globules

absent

0

 

regular

0

 

irregular

1

regression pattern

absent

0

 

present

1

 

score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

• A score >= 3 indicates a lesion at increased risk for being a melanoma. Only melanomas had a score >= 8 in the original series.

 

Performance:

• Overall diagnostic sensitivity 85-95% with specificity 45-75%, depending on experience of the observer.


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Specialty

Objective

ICD-10