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Microsc Microanal. 2014 Oct;20(5):1356-64. doi: 10.1017/S1431927614013063. Epub 2014 Sep 8.

High-resolution episcopic microscopy (HREM): a tool for visualizing skin biopsies.

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1MRC National Institute for Medical Research,London,NW7 1AA,UK.
2Centre for Anatomy and Cell Biology,Medical University of Vienna,Waehringer Street 13,A-1090 Vienna,Austria.


We evaluate the usefulness of digital volume data produced with the high-resolution episcopic microscopy (HREM) method for visualizing the three-dimensional (3D) arrangement of components of human skin, and present protocols designed for processing skin biopsies for HREM data generation. A total of 328 biopsies collected from normally appearing skin and from a melanocytic nevus were processed. Cuboidal data volumes with side lengths of ~2×3×6 mm3 and voxel sizes of 1.07×1.07×1.5 µm3 were produced. HREM data fit ideally for visualizing the epidermis at large, and for producing highly detailed volume and surface-rendered 3D representations of the dermal and hypodermal components at a structural level. The architecture of the collagen fiber bundles and the spatial distribution of nevus cells can be easily visualized with volume-rendering algorithms. We conclude that HREM has great potential to serve as a routine tool for researching and diagnosing skin pathologies.

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