Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi

Background: Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represents a challenge even for experienced dermoscopists, as dermoscopy alone is not sufficient to adequately differentiate these equivocal melanocytic skin lesions (MSLs). Objectives: The object...

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Autores principales:	Linda Tognetti, Elisa Cinotti, Elvira Moscarella, Francesca Farnetani, Josep Malvehy, Aimilios Lallas, Giovanni Pellacani, Giuseppe Argenziano, Gabriele Cevenini, Pietro Rubegni
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2018
Materias:	melanoma atypical nevi dermoscopy clinical and personal data Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/5d454682468d4548ae4ba58b60bcd853
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spelling	oai:doaj.org-article:5d454682468d4548ae4ba58b60bcd8532021-11-17T08:29:53ZImpact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi10.5826/dpc.0804a162160-9381https://doaj.org/article/5d454682468d4548ae4ba58b60bcd8532018-10-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/503https://doaj.org/toc/2160-9381 Background: Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represents a challenge even for experienced dermoscopists, as dermoscopy alone is not sufficient to adequately differentiate these equivocal melanocytic skin lesions (MSLs). Objectives: The objectives of this study were to investigate what were the most relevant parameters for noninvasive differential diagnosis between eMM and aN among clinical, personal, and dermoscopic data and to evaluate their impact as risk factors for malignancy. Methods: This was a retrospective study performed on 450 MSLs excised from 2014 to 2016 with a suspicion of malignancy. Dermoscopic standardized images of the 450 MSLs (300 aN and 150 eMM) were collected and evaluated. Patients’ personal data (ie, age, gender, body site, maximum diameter) were also recorded. Dermoscopic evaluations were performed by 5 different experts in dermoscopy blinded to histopathological diagnosis. Fleiss’ κ was calculated to measure concordance level between experts in the description of dermoscopic parameters for each MSLs. The power of the studied variables in discriminating malignant from benign lesions was also investigated through F-statistics. Results: The variables age and maximum diameter supplied the highest discriminant power (F = 253 and 227, respectively). Atypical network, blue white veil and white shiny streaks were the most significant dermoscopic patterns suggestive of malignancy (F = 110, 104 and 99.5, respectively). Shiny white streaks was the only dermoscopic parameter to obtain satisfactory concordance value. Gender was not a discriminant factor. The specific statistical weight of clinical and personal data (ie, “patient’s age” and “lesion diameter”) surpassed those of atypical dermoscopic features. Conclusions: The objective clinical and personal data collected here could supply a fundamental contribution in the correct diagnosis of equivocal MSLs and should be included in diagnostic algorithms along with significant dermoscopic features (ie, atypical network, blue-white veil, and shiny white streaks). Linda TognettiElisa CinottiElvira MoscarellaFrancesca FarnetaniJosep MalvehyAimilios LallasGiovanni PellacaniGiuseppe ArgenzianoGabriele CeveniniPietro RubegniMattioli1885articlemelanomaatypical nevidermoscopyclinical and personal dataDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 8, Iss 4 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	melanoma atypical nevi dermoscopy clinical and personal data Dermatology RL1-803
spellingShingle	melanoma atypical nevi dermoscopy clinical and personal data Dermatology RL1-803 Linda Tognetti Elisa Cinotti Elvira Moscarella Francesca Farnetani Josep Malvehy Aimilios Lallas Giovanni Pellacani Giuseppe Argenziano Gabriele Cevenini Pietro Rubegni Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
description	Background: Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represents a challenge even for experienced dermoscopists, as dermoscopy alone is not sufficient to adequately differentiate these equivocal melanocytic skin lesions (MSLs). Objectives: The objectives of this study were to investigate what were the most relevant parameters for noninvasive differential diagnosis between eMM and aN among clinical, personal, and dermoscopic data and to evaluate their impact as risk factors for malignancy. Methods: This was a retrospective study performed on 450 MSLs excised from 2014 to 2016 with a suspicion of malignancy. Dermoscopic standardized images of the 450 MSLs (300 aN and 150 eMM) were collected and evaluated. Patients’ personal data (ie, age, gender, body site, maximum diameter) were also recorded. Dermoscopic evaluations were performed by 5 different experts in dermoscopy blinded to histopathological diagnosis. Fleiss’ κ was calculated to measure concordance level between experts in the description of dermoscopic parameters for each MSLs. The power of the studied variables in discriminating malignant from benign lesions was also investigated through F-statistics. Results: The variables age and maximum diameter supplied the highest discriminant power (F = 253 and 227, respectively). Atypical network, blue white veil and white shiny streaks were the most significant dermoscopic patterns suggestive of malignancy (F = 110, 104 and 99.5, respectively). Shiny white streaks was the only dermoscopic parameter to obtain satisfactory concordance value. Gender was not a discriminant factor. The specific statistical weight of clinical and personal data (ie, “patient’s age” and “lesion diameter”) surpassed those of atypical dermoscopic features. Conclusions: The objective clinical and personal data collected here could supply a fundamental contribution in the correct diagnosis of equivocal MSLs and should be included in diagnostic algorithms along with significant dermoscopic features (ie, atypical network, blue-white veil, and shiny white streaks).
format	article
author	Linda Tognetti Elisa Cinotti Elvira Moscarella Francesca Farnetani Josep Malvehy Aimilios Lallas Giovanni Pellacani Giuseppe Argenziano Gabriele Cevenini Pietro Rubegni
author_facet	Linda Tognetti Elisa Cinotti Elvira Moscarella Francesca Farnetani Josep Malvehy Aimilios Lallas Giovanni Pellacani Giuseppe Argenziano Gabriele Cevenini Pietro Rubegni
author_sort	Linda Tognetti
title	Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
title_short	Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
title_full	Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
title_fullStr	Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
title_full_unstemmed	Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
title_sort	impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi
publisher	Mattioli1885
publishDate	2018
url	https://doaj.org/article/5d454682468d4548ae4ba58b60bcd853
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Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi

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