Improvement of malignant/benign ratio in excised melanocytic lesions in the 'dermoscopy era': a retrospective study 1997-2001

Abstract

The adoption of dermoscopy in routine melanoma screening is followed by an improvement of the malignant/benign ratio in excised lesions, suggesting a more appropriate selection of pigmented lesions referred to surgery. Because of the possible limitations of a retrospective study design, future confirmation of this finding by means of a prospective, randomized study is advisable. The introduction of dermoscopy in routine practice may have major implications in large-scale melanoma screening with cost savings and a reduction of the dermosurgery workload.

Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy

“…Nevertheless, dermoscopy showed a better specificity when used by well-trained and experienced dermoscopists [7]. In addition, the specificity of dermoscopy was indirectly measured through observation of improvements in the malignant/benign ratio of excised lesions [8]. A study conducted in 13 countries between 1998 and 2007 demonstrated that clinics with dermoscopy perform fewer total number of excisions as compared to clinics without dermoscopy [9].…”

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

“…From a meta-analysis of nine level II diagnostic studies subject to varying degrees of verification bias performed prospectively in a clinical setting the diagnostic accuracy for melanoma, as expressed by the relative diagnostic odds ratio, was 15.6 (95 % CI 2.9-83.7) times higher for dermoscopy compared with naked eye examination [26][27][28][29][30][31][32][33][34][35][36]." ([19] p. 29).…”

“…Two such studies suggest reduced rates of excision of benign lesions using dermoscopy (reduced benign to malignant ratio of excised lesions and reduction of patients referred to biopsy) and provide indirect evidence for improved specificity in a specialist setting [31,32]." ([19], p. 29).…”

Dermoscopy for the diagnosis of melanoma: primary care diagnostic technology update

“…Several researchers have commented that dermoscopy in routine practice may have major implications in large-scale melanoma screening, with a reduction in the dermatological surgery workload of false-positive lesions, leading to cost savings, reduced morbidity, and less scarring. 12 It may be cost-effective due to the decreased number of excised benign lesions and the early detection of melanomas. 13 In terms of patient-reported outcomes, a study estimating patients' willingness to pay for handheld dermoscopy, digital dermoscopy, and teledermoscopy was reported to be 40% below a hypothetical method promising 100% accuracy, yet higher than that reported for naked-eye inspection.…”