Dermoscopy of early melanomas: variation according to the anatomic site

Tognetti, Linda; Cartocci, Alessandra; Cinotti, Élisa; Moscarella, Elvira; Farnetani, Francesca; Carrera, Cristina; Lallas, Aimilios; Tiodorović, Danica; Longo, Caterina; Puig, Susana; Perrot, Jean; Argenziano, Giuseppe; Pellacani, Giovanni; Cataldo, Gennaro; Balistreri, Alberto; Cevenini, Gabriele; Rubegni, Pietro

doi:10.1007/s00403-021-02226-x

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…In addition, we also debate whether a certain degree of overdiagnosis of in situ MM might have took place in the last decade worldwide [7][8][9][10]. In this context, a reasonable way out seems to be to follow a global approach to the patient integrating dermoscopic imaging with multiple risk assessment tools and personal plus lesional data [7,[11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

An updated algorithm integrated with patient data for the differentiation of atypical nevi from early melanomas: the idScore 2021

Tognetti

Cartocci

Bertello

et al. 2022

Dermatol Pract Concept

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Background: It is well known that multiple patient-related risk factors contribute to the development of cutaneous melanoma, including anagraphic, phenotypic and anamnestic factors. Objectives: We aimed to investigate which MM risk factors were relevant to be incorporated in a risk scoring-classifier based clinico-dermoscopic algorithm. Methods: This retrospective study was performed on a monocentric dataset of 374 atypical melanocytic skin lesions (aMSLs) sharing equivocal dermoscopic features, excised in the suspicion of malignancy. Dermoscopic standardized images of 258 atypical nevi and 116 early melanomas were collected along with objective lesional data (i.e., maximum diameter, specific body site and body area) and 7 dermoscopic data. All cases were combined with a series of 10 MM risk factors, including anagraphic (2), phenotypic (5) and anamnestic (3) ones. Results: According to the stepwise analysis logistic regression, the proposed iDScore 2021 algorithm is composed by 9 variables, including 3 patient data (age, skin phototype I/II, personal/familiar history of MM), 2 lesion characteristics (maximum diameter, location on the lower extremities (thighs/legs/ankles/back of the feet) and 4 dermoscopic features (irregular dots and globules, irregular streaks, blue gray peppering, blue white veil). The algorithm assigned to each lesion/case a progressive score from 0 to 18. The performance obtained in the ROC curve analysis reached 92% AUC in differentiating early melanomas from atypical nevi. Conclusions: An integrated checklist combining multiple anamnestic data with selected relevant dermoscopic features can be useful in the differential diagnosis and management of early melanomas and atypical nevi exhibiting equivocal features.

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Section: Introductionmentioning

confidence: 99%

An updated algorithm integrated with patient data for the differentiation of atypical nevi from early melanomas: the idScore 2021

Tognetti

Cartocci

Bertello

et al. 2022

Dermatol Pract Concept

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“…This has a negative impact on healthcare costs and aesthetic outcomes 31,35 . Histology remains the gold standard for diagnostic confirmation, though in some cases it may be challenging for the pathologist to differentiate between early LM and ultraviolet‐induced melanocytic hyperplasia in chronically sun‐damaged skin 1,32,36 …”

Section: Discussionmentioning

confidence: 99%

“…31,35 Histology remains the gold standard for diagnostic confirmation, though in some cases it may be challenging for the pathologist to differentiate between early LM and ultraviolet-induced melanocytic hyperplasia in chronically sun-damaged skin. 1,32,36 The present scoring classifier-based model is innovative in many respects. Firstly, it was specifically designed to differentiate LM/LMM from five simulators (PAK/SL/BLK/AN/ SK) instead of being limited to a univocal differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

A risk‐scoring model for the differential diagnosis of lentigo maligna and other atypical pigmented facial lesions of the face: The facial iDScore

Tognetti,

Cartocci,

Żychowska

et al. 2023

Acad Dermatol Venereol

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BackgroundDue to progressive ageing of the population, the incidence of facial lentigo maligna (LM) of the face is increasing. Many benign simulators of LM and LMM, known as atypical pigmented facial lesions (aPFLs—pigmented actinic keratosis, solar lentigo, seborrheic keratosis, seborrheic‐lichenoid keratosis, atypical nevus) may be found on photodamaged skin. This generates many diagnostic issues and increases the number of biopsies, with a subsequent impact on aesthetic outcome and health insurance costs.ObjectivesOur aim was to develop a risk‐scoring classifier‐based algorithm to estimate the probability of an aPFL being malignant. A second aim was to compare its diagnostic accuracy with that of dermoscopists so as to define the advantages of using the model in patient management.Materials and MethodsA total of 154 dermatologists analysed 1111 aPFLs and their management in a teledermatology setting: They performed pattern analysis, gave an intuitive clinical diagnosis and proposed lesion management options (follow‐up/reflectance confocal microscopy/biopsy). Each case was composed of a dermoscopic and/or clinical picture plus metadata (histology, age, sex, location, diameter). The risk‐scoring classifier was developed and tested on this dataset and then validated on 86 additional aPFLs.ResultsThe facial Integrated Dermoscopic Score (iDScore) model consisted of seven dermoscopic variables and three objective parameters (diameter ≥ 8 mm, age ≥ 70 years, male sex); the score ranged from 0 to 16. In the testing set, the facial iDScore‐aided diagnosis was more accurate (AUC = 0.79 [IC 95% 0.757–0.843]) than the intuitive diagnosis proposed by dermatologists (average of 43.5%). In the management study, the score model reduced the number of benign lesions sent for biopsies by 41.5% and increased the number of LM/LMM cases sent for reflectance confocal microscopy or biopsy instead of follow‐up by 66%.ConclusionsThe facial iDScore can be proposed as a feasible tool for managing patients with aPFLs.

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“…Multiple tightly packed papillae with red, brown dots, linear or looped vessels; white halos around looped vessels in some cases; irregular red, black, brown bleeding or scabs (12,29,30).…”

Section: Verruca Vulgarismentioning

confidence: 99%

Dermoscopic Features Summarization and Comparison of Four Types of Cutaneous Vascular Anomalies

et al. 2021

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Objective: Dermoscopic features of cutaneous vascular anomalies have been reported, but the described features currently known are limited and not well-understood. The aim of this study is to comprehensively summarize and compare the dermoscopic features of the four different types of cutaneous vascular anomalies [infantile hemangiomas (IH), cherry angioma (CA), angiokeratomas (AK), and pyogenic granuloma (PG)] in the Chinese Han population.Materials and Methods: Dermoscopic features of 31 IH, 172 CA, 31 AK, and 45 PG were collected based on the contact non-polarized mode of dermoscopy at 20-fold magnification. Dermoscopic features including background, lacunae, vessel morphology and distribution were collected and summarized. Additionally, we compared these features by age stage, gender, and anatomical locations in CA.Results: The dermoscopic features of IH included the red lacunae, red/red-blue/red-white backgrounds, and vessel morphology such as linear curved vessels, serpiginous vessels, coiled vessels. For CA, the lacunae appeared reddish brown to reddish blue or only red. In terms of vascular morphology, serpentine vessels, coiled vessels, looped vessels, and curved vessels could be seen in the lesions. A few lesions were black or presented with a superficial white veil. There were statistical differences in red background (P = 0.021), unspecific vessel distribution (P = 0.030), black area (P = 0.029), and white surface (P = 0.042) among different age groups. Red-brown lacunae (P = 0.039), red-blue (P = 0.013), red-white background (P = 0.015), black area (P = 0.016), and white surface (P = 0.046) were of statistical difference in terms of the locations of lesions. Lacunae were also observed in AK, which presented with red, dark purple, dark blue, black. Global dermoscopic patterns that were characterized by a homogeneous area were obvious in all PG lesions, among which 30 (66.7%) were red-white and 15 (33.3%) were red. As for local features, “white rail” lines were detected in 19 (42.2%) lesions and white collarette was seen in 34 (75.6%) lesions.Conclusions: Dermoscopy is an applicable diagnostic tool for the diagnosis of cutaneous vascular anomalies. It is necessary to take into account the age stage and lesion location when we diagnose CA using dermoscopy.

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Dermoscopy of early melanomas: variation according to the anatomic site

Cited by 9 publications

References 26 publications

An updated algorithm integrated with patient data for the differentiation of atypical nevi from early melanomas: the idScore 2021

An updated algorithm integrated with patient data for the differentiation of atypical nevi from early melanomas: the idScore 2021

A risk‐scoring model for the differential diagnosis of lentigo maligna and other atypical pigmented facial lesions of the face: The facial iDScore

Dermoscopic Features Summarization and Comparison of Four Types of Cutaneous Vascular Anomalies

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