Diagnostic accuracy of dermoscopy

Kittler, Harald; Pehamberger, Hubert; Wolff, K; Binder, Michael

doi:10.1016/s1470-2045(02)00679-4

Cited by 1,111 publications

(437 citation statements)

References 36 publications

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“…In the hands of experienced users, the device helps to improve clinical diagnostic accuracy 3,4 , and increase physicians' confidence 5 in their clinical diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Wang

Dusza

Scope

et al. 2008

Dermatologic Surgery

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Objective: To evaluate whether the differences in colors and structures observed in dermoscopic images from non-polarized dermoscopes (NPD) and polarized dermoscopes (PD) can impact physicians' diagnostic ability and their confidence levels.Participants: 100 dermatologists who attended a one-day course on the fundamental of dermoscopy course at Memorial Sloan-Kettering Cancer Center.Design: Twenty five pigmented lesions were chosen, which consisted of 7 seborrheic keratoses, 3 basal cell carcinomas, 2 atypical nevi, 5 melanomas, 3 dermatofibromas, 3 blue nevi and 2 hemangiomas. Two images of each lesion (one NPD and one PD) for a total of 50 lesions were included in the image presentation. Participants were not informed of the study design and were not told that they would be viewing the same lesions under 2 different imaging modalities. Statistical analysis examining the participants' responses was performed using the McNemar's test and Paired t test.Main Outcome Measures: The main outcomes included the assessment of the diagnostic accuracy and confidence level for clinicians viewing lesions via NPD and PD.Results: Ninty-one participants completed the study. Statistically significant differences in the diagnoses were observed in the seborrheic keratosis, atypical nevus and melanoma groups. For seborrehic keratosis, 75% and 59% of the final participants correctly diagnosed SK when presented with the NPD and PD images, respectively. For atypical nevi, 19% and 33% had the correct diagnoses when presented with NPD and PD images, respectively. For melanomas, 23% and 34% had correct diagnoses with the NPD and PD images, respectively. For the categories of seborrehic keratosis and atypical nevus, participants were statistically more confident in their diagnoses when presented with the NPD images than with the PD images. For the category of basal cell carcinoma, participants were more confident in their diagnosis when viewing the PD images compared to the NPD images.Conclusion: There are observed differences between NPD and PD in term of the color and structure visualized. In some cases, physicians diagnostic accuracy and confidence are affected by the differences seen with the different dermoscopes. NPD and PD appears to provide different but complementary information.

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“…In the hands of experienced users, the device helps to improve clinical diagnostic accuracy 3,4 , and increase physicians' confidence 5 in their clinical diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Wang

Dusza

Scope

et al. 2008

Dermatologic Surgery

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“…[1][2][3][4] In recent years, dermatoscopes that use cross-polarization technology have been introduced and are increasingly used. [5][6][7] However, there are clinically relevant and notable differences between lesion appearance under polarized dermatoscopy (PD) and non-PD.…”

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confidence: 99%

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

Balagula¹,

Braun²,

Rabinovitz³

et al. 2012

Journal of the American Academy of Dermatology

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BACKGROUND: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. OBJECTIVES: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. METHODS: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. RESULTS: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P < .001). The prevalence of CS correlated with increased melanoma thickness (P = .001). LIMITATIONS: Biopsied lesions represent a small percentage of the total number of lesions evaluated. CONCLUSION: Among biopsied malignant lesions, CS are most commonly observed in basal cell carcinoma and invasive melanomas and rarely seen in nevi. In melanoma, CS may reflect increased tumor thickness and progression. (2) Background: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy.

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“…This is related to the fact that dermatoscopy has not been proven to improve diagnosis for untrained or less experienced examiners, which applies to most GPs [17].…”

Section: Discussionmentioning

confidence: 99%

Skin Melanomas Excised by General Practitioners: More Often Unsuspected, of Nodular Type and Less of Often Radically Excised Than Those Excised in an Academic Setting

Buis¹,

Kemenade²,

Frijling³

et al. 2011

J Clin Exp Dermatol

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Diagnostic accuracy of dermoscopy

Cited by 1,111 publications

References 36 publications

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

Differences in Dermoscopic Images from Nonpolarized Dermoscope and Polarized Dermoscope Influence the Diagnostic Accuracy and Confidence Level: A Pilot Study

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

Skin Melanomas Excised by General Practitioners: More Often Unsuspected, of Nodular Type and Less of Often Radically Excised Than Those Excised in an Academic Setting

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