Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions

Objectives: To evaluate the frequency of misclassifications of equivocal pigmented lesions according to the first step of the dermatoscopic 2-step algorithm. Patients and Methods: 707 consecutive cases from 553 patients of central Europe and Australia were included in the study. Dermatoscopic im...

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Autores principales:	Philipp Tschandl, Cliff Rosendahl, Harald Kittler
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2012
Materias:	Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/cdc51c4728c7400d922eadaa9dfe0750
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spelling	oai:doaj.org-article:cdc51c4728c7400d922eadaa9dfe07502021-11-17T08:33:04ZAccuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions10.5826/dpc.0203a082160-9381https://doaj.org/article/cdc51c4728c7400d922eadaa9dfe07502012-07-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1181https://doaj.org/toc/2160-9381 Objectives: To evaluate the frequency of misclassifications of equivocal pigmented lesions according to the first step of the dermatoscopic 2-step algorithm. Patients and Methods: 707 consecutive cases from 553 patients of central Europe and Australia were included in the study. Dermatoscopic images were evaluated in a blinded fashion for the presence of features described in the 2-step algorithm to determine their melanocytic or non-melanocytic origin. Mucosal, genital and non-pigmented lesions were excluded. Results: The sensitivity of the first step was 97.1% for patients from Australia and 96.8% for patients from central Europe. The specificity was 33.6% for Australian patients and 67.9% for European patients. The most common reasons for misclassification were the presence of a pigmented network in a non-melanocytic lesion (n=68, 25.2%) and the absence of dermatoscopic features of melanocytic and non-melanocytic lesions in 69 (25.6%) non-melanocytic lesions. Conclusion: The first step of the dermatoscopic 2-step algorithm, if applied consistently, has high sensitivity but low specificity. Many non-melanocytic lesions, especially solar lentigines and seborrheic keratoses, are wrongly classified as melanocytic. The worse performance of the first step algorithm in Australian patients is probably due to a higher rate of solar lentigines in patients with severely sun-damaged skin. Philipp TschandlCliff RosendahlHarald KittlerMattioli1885articleDermatologyRL1-803ENDermatology Practical & Conceptual (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dermatology RL1-803
spellingShingle	Dermatology RL1-803 Philipp Tschandl Cliff Rosendahl Harald Kittler Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
description	Objectives: To evaluate the frequency of misclassifications of equivocal pigmented lesions according to the first step of the dermatoscopic 2-step algorithm. Patients and Methods: 707 consecutive cases from 553 patients of central Europe and Australia were included in the study. Dermatoscopic images were evaluated in a blinded fashion for the presence of features described in the 2-step algorithm to determine their melanocytic or non-melanocytic origin. Mucosal, genital and non-pigmented lesions were excluded. Results: The sensitivity of the first step was 97.1% for patients from Australia and 96.8% for patients from central Europe. The specificity was 33.6% for Australian patients and 67.9% for European patients. The most common reasons for misclassification were the presence of a pigmented network in a non-melanocytic lesion (n=68, 25.2%) and the absence of dermatoscopic features of melanocytic and non-melanocytic lesions in 69 (25.6%) non-melanocytic lesions. Conclusion: The first step of the dermatoscopic 2-step algorithm, if applied consistently, has high sensitivity but low specificity. Many non-melanocytic lesions, especially solar lentigines and seborrheic keratoses, are wrongly classified as melanocytic. The worse performance of the first step algorithm in Australian patients is probably due to a higher rate of solar lentigines in patients with severely sun-damaged skin.
format	article
author	Philipp Tschandl Cliff Rosendahl Harald Kittler
author_facet	Philipp Tschandl Cliff Rosendahl Harald Kittler
author_sort	Philipp Tschandl
title	Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
title_short	Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
title_full	Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
title_fullStr	Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
title_full_unstemmed	Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
title_sort	accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions
publisher	Mattioli1885
publishDate	2012
url	https://doaj.org/article/cdc51c4728c7400d922eadaa9dfe0750
work_keys_str_mv	AT philipptschandl accuracyofthefirststepofthedermatoscopic2stepalgorithmforpigmentedskinlesions AT cliffrosendahl accuracyofthefirststepofthedermatoscopic2stepalgorithmforpigmentedskinlesions AT haraldkittler accuracyofthefirststepofthedermatoscopic2stepalgorithmforpigmentedskinlesions
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Accuracy of the first step of the dermatoscopic 2-step algorithm for pigmented skin lesions

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