LED Loupe Dermoscopy
A budget alternative to traditional dermoscopy is to use a magnifying loupe such as this device used for measuring thread counts when inspecting linen.
This was presented some years ago as a tool for resource poor settings such as in the developing world, but has received some popularity amongst non-specialists for an easy and budget friendly introduction into dermoscopy.
It has illumination and magnification and when used with fluid such as alcohol gel for immersion can be good enough to see some signs that can help with diagnoses and particularly with confirming benign lesions.
Something to consider if you’re still not sure if dermoscopy is something you want to invest in!
This is a photograph of a basal cell carcinoma taken through an eyepiece scale loupe.
The smartphone digiscoping adaptor is an inexpensive tool which is normally used in wildlife photography to connect either a compact camera or smartphone to a telescope.
However, these can also be used to attach your smartphone to an LED magnifying loupe very easily. They may also work on some dermatoscopes.
This provides a wide reaching, more accessible alternative to a traditional dermatoscope.
Are the images comparable to traditional dermoscopy?
A small study performed by our team (Bridgewater, K et al., 2022) demonstrated that GPs and GP trainees correctly referred 80.6% of skin lesions to Dermatology with the use of loupe dermatoscopic photographs, compared to 65.1% of correct referrals to Dermatology using just macroscopic photographs. This was a statistically significant difference.The study also found that there was no significant difference in referral accuracy when comparing loupe versus dermatoscopic images.
Bridgewater, K., Levene, A., Lun, A. and Keith, D. (2022), The LED loupe magnifier: a cost-effective method of dermoscopic examination and photography of skin lesions in primary care and beyond. J Eur Acad Dermatol Venereol. https://doi-org.bris.idm.oclc.org/10.1111/jdv.18448
Build your own! A step by step guide
Step 1
Gather your equipment:
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Smartphone
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Digiscoping adaptor (left)
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LED magnifying loupe (top)
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Smartphone with camera
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Clear liquid e.g. alcohol gel
Step 2
Place the lower end of your smartphone in the digiscoping adapter clamp, making sure the octagonal element is resting against the upper part of the back of your phone (see step 3 for back view).
Step 3
Back view. You may need to adjust the clamp in order to fit your phone securely inside, by turning the screw over the side of the clamp, labelled here.
Make sure your phone's camera can be positioned in the middle of the octagonal element. You may need to move the clamp up on your phone, so it reaches the camera.
Step 4
Secure your phone onto the digiscoping adapter by twisting the screw on the side of the clamp, as shown.
Step 5
Position the octagonal element of the digiscoping adapter over the camera of your smartphone.
NB the octagonal element does not need to be perpendicular, it can be at an angle.
Step 6
Secure this in place with the twisting screw on the back of the adapter, as shown here.
Step 7
Place the magnifying loupe inside the octagonal element of the digiscoping adapter.
Step 8
Secure the magnifying loupe in place by gently tightening the long screw above the loupe, as shown here.
Step 9
This is how it should look with the elements assembled and secured.
Step 10
Turn the magnifying loupe on using the small white switch on the side of the device as shown here. You should see an LED light come on.
Step 11
Open your phone's camera app and ensure the field of view is satisfactory. Adjust if necessary.
Step 12
Lay the assembly down with the lens facing up. Apply a small amount of clear liquid or gel (e.g. alcohol gel) over the lens of the magnifying loupe.
Step 13
Place the lens of the loupe directly over the lesion you wish to examine, ensuring it makes direct contact with the skin
An additional image demonstrating direct contact of the loupe with the skin.
Now interpret your findings and take a photograph if desired!