Disposable polythene cover of the suture: An inexpensive tool to examine the orogenital skin and mucosa and to prevent cross-infection during the dermoscopic examination

Problem

Dermoscopy is routinely used for the examination of various orogenital dermatoses and cutaneous infections. During contact dermoscopy, the glass face plate of the dermoscope comes directly in contact with the patient’s skin. This can rarely lead to cross infections and can create doubt about the hygiene of the procedure particularly when used in the orogenital area. None of the commercially available dermoscope provides any disposable transparent barrier cover/film, except for DermLite, DL4 (USA, 10x magnification) and DermLite handyscope (USA, 10x magnification), which come with disposable caps; however, these are not universally available.

Solution

To overcome this difficulty, we used the disposable polythene cover of the suture material [Figure 1a]. During the preparation of the surgical tray for skin biopsy and dermatosurgical procedures, the suture covers were separated, sanitised using alcohol-based sanitisers, and kept separately in a sterile container. These stored polythene covers were used as an interface between contact plate of dermoscope and skin while examining genitalia [Figure 1b], lip, tongue and infected cutaneous lesions. The dimension of a standard cover is 13 cm × 6.5 cm, and it comfortably accommodates the maximum diameter of the contact plates of DermLite DL4® (USA, 10x magnification), Heine Delta 20T® (Germany) and Heine Delta 30® (Germany).

Close

Figure 1:

(a) Disposable polythene cover of the suture. (b) Genital lichen planus. (c) Demonstration of the use of the disposable polythene cover (green arrow) in a case of genital lichen planus. The red arrow shows Wickham’s striae. (d) Dermoscopy (Polarized mode, DermLite DL4, 10×) shows Wickham’s striae. (e) Multiple scrotal sebaceous cysts. (f) Dermoscopy (Polarized mode, DermLite DL4, 10×) shows yellow to yellow-white homogeneous areas.

Export to PPT

The advantages of disposable polythene cover of suture material over previously reported plastic wrap are: (1) It is free of cost and readily available. (2) There is no need to cut it from a big plastic film, which can be time-consuming. (3) There is no need for a rubber band or metal cable tie to keep it in position. (4) There was no significant change in dermoscopic structure visibility by using it [Figures 1c–f]. Prior reported cases did not comment on the clarity or provide dermoscopic images.¹ This is a low cost modification which can allow safe dermoscopy of any dermatoses in HIV positive, lepromatous leprosy and secondary syphilis patients.