Dark pigmented lesions: Diagnostic accuracy of dermoscopy and reflectance confocal microscopy in a tertiary referral center for skin cancer diagnosis.
Adult
Biopsy
Dermoscopy
/ statistics & numerical data
Diagnosis, Differential
Female
Humans
Male
Melanoma
/ diagnosis
Microscopy, Confocal
/ statistics & numerical data
Middle Aged
Nevus, Pigmented
/ diagnosis
Prospective Studies
Sensitivity and Specificity
Skin
/ diagnostic imaging
Skin Neoplasms
/ diagnosis
Tertiary Care Centers
/ statistics & numerical data
dermatoscopy
diagnosis
melanocytic
melanoma
nevus
noninvasive
reflectance confocal microscopy
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
20
05
2020
revised:
09
07
2020
accepted:
23
07
2020
pubmed:
31
7
2020
medline:
31
8
2021
entrez:
31
7
2020
Statut:
ppublish
Résumé
There is lack of studies on the diagnostic accuracy of dermoscopy and reflectance confocal microscopy (RCM) for dark pigmented lesions. To assess the diagnostic accuracy of dermoscopy plus confocal microscopy for melanoma diagnosis of dark pigmented lesions in real life. Prospective analysis of difficult dark lesions with clinical/dermoscopic suspicion of melanoma referred for RCM for further analysis. The outcome could be excision or dermoscopic digital follow-up. We included 370 clinically dark lesions from 350 patients (median age, 45 y). Because of the clinical/dermoscopic/RCM approach, we saved 129 of 213 unnecessary biopsies (specificity of 60.6%), with a sensitivity of 98.1% (154/157). The number needed to excise with the addition of RCM was 1.5 for melanoma diagnosis. Single institution based; Italian population only. This study showed that RCM coupled with dermoscopy increases the specificity for diagnosing melanoma, and it helps correctly identify benign lesions. Our findings provide the basis for subsequent prospective studies on melanocytic neoplasms belonging to patients in different countries.
Sections du résumé
BACKGROUND
BACKGROUND
There is lack of studies on the diagnostic accuracy of dermoscopy and reflectance confocal microscopy (RCM) for dark pigmented lesions.
OBJECTIVE
OBJECTIVE
To assess the diagnostic accuracy of dermoscopy plus confocal microscopy for melanoma diagnosis of dark pigmented lesions in real life.
METHODS
METHODS
Prospective analysis of difficult dark lesions with clinical/dermoscopic suspicion of melanoma referred for RCM for further analysis. The outcome could be excision or dermoscopic digital follow-up.
RESULTS
RESULTS
We included 370 clinically dark lesions from 350 patients (median age, 45 y). Because of the clinical/dermoscopic/RCM approach, we saved 129 of 213 unnecessary biopsies (specificity of 60.6%), with a sensitivity of 98.1% (154/157). The number needed to excise with the addition of RCM was 1.5 for melanoma diagnosis.
LIMITATIONS
CONCLUSIONS
Single institution based; Italian population only.
CONCLUSIONS
CONCLUSIONS
This study showed that RCM coupled with dermoscopy increases the specificity for diagnosing melanoma, and it helps correctly identify benign lesions. Our findings provide the basis for subsequent prospective studies on melanocytic neoplasms belonging to patients in different countries.
Identifiants
pubmed: 32730850
pii: S0190-9622(20)32285-4
doi: 10.1016/j.jaad.2020.07.084
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1568-1574Informations de copyright
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.