Diascope: indications, preparation, results
Diascope (MicroProse) – a diagnostic procedure in dermatology to characterize elements of the rash on their properties and used for the differential diagnosis. Due to its simplicity and undemanding to equipment, diascope widely used in clinical practice for patients with various skin diseases (psoriasis, inflammatory lesions, etc.). In addition, diascopy does not have any contraindications to its use, because this is a non-invasive, without the use of any drugs.
Indications and contraindications
As with any diagnostic method, diascope has certain indications for its conduct. As a rule, this procedure is used when necessary differential diagnosis elements of skin rash, in particular, to determine hyperemic or hemorrhagic (due to the expansion of blood vessels and increase blood supply to) the nature of the lesions. A similar situation can occur in various diseases: psoriasis, idiopathic thrombocytopenic purpura, systemic lupus erythematosus and so on. In addition, vicepresi used to detect cutaneous tuberculosis and sarcoidosis, so as to hold between them a clear distinction is very difficult.
The main tools for carrying out vicepresi subject or hour glass, preferably transparent and with straight edges. As a rule, examinations are held in natural light, changing the color of the lesions. Doctor gently presses the glass to the skin of the patient at the site of lesions.
When pressed in the surface layers of the skin is broken the blood supply, which allows to distinguish between the rash associated with bleeding in the skin, and rash associated with enlargement of blood capillaries, which can occur during inflammation or in the case of telangiectasia. If the rash is hemorrhagic or pigmented nature of origin, the color elements does not change with pressure.
Color changes skin rash help to determine the nature of the rash: whether it is connected with the expansion of the capillaries, or were bleeding into the skin.
The detection of tuberculous lesions of the skin is of great importance, «the phenomenon of Apple jelly». The tubercles result from the termination of the blood supply to become yellowish-brown colour, characteristic for the specified jelly, which allows a visual differential diagnosis. A similar phenomenon, for example, is not characteristic for cutaneous sarcoidosis, also leading to the emergence of tubercles.
Despite its simplicity and availability in any medical institution, diascope widely used due to its high diagnostic value and possibilities of differential diagnostics between inflammatory and noninflammatory skin lesions.
Preparation of the patient
Special preparation of the patient for holding vicepresi not required, however, there are several guidelines which must be adhered to:
- Prior to diascopia patients should tell their doctor about when there was a rash of what he connects them, and which drugs (including topical application) it is used.
- Before microbreccia is not recommended to apply on rash any of the ointments or creams because they can change the reaction vessels and not allow it to give unequivocal results.
- The slide in any case should not be cold or hot, as this can lead to reflex spasm or expansion of the capillaries, consequently, to misinterpretation of what he saw of the picture. The optimum temperature is 23-25C.
- The skin of the patient needs to be clean, but to wash them using soap or other means immediately before the procedure, as it can cause local irritation and enlargement of the capillaries.
Compliance with these recommendations allows to increase the diagnostic value of the procedure and reduce the likelihood of errors.
It is important to remember that the interpretation of vicepresi very much depends on the experience of the attending physician, therefore, this method should not be used as the sole. Usually doctors use a comprehensive dermatological examination, allows you to set the most accurate diagnosis in connection with the existing clinical symptoms and data of objective research methods.
Thus, diascope – the most important auxiliary method for diagnosis in dermatology, allowing to establish the nature of the lesions by using objective method. The speed of implementation, reliability of results and the lack of special preparation for the study lead to the widespread use of vicepresi in clinical practice. However, it is important to remember about the existing limitations associated with the lack of objectivity of this method of determining the nature of skin rashes.