The prevalent dermoscopic criterion to distinguish between benign and suspicious pink tumours

Abstract

Background Pink skin tumours are difficult to differentiate, clinically and dermoscopically. In previous studies, mainly focused on pigmented lesions, pattern analysis provided the best sensitivity and specificity values, as compared to other algorithms. These findings suggest that the global dermoscopic appearance, based on the evaluation of prevalent features, could represent a valuable and practical approach even when dealing with pink lesions.Objective In this study, we aimed to evaluate the diagnostic accuracy of a new dermoscopic approach for pink tumours based on the prevalent criterion, as compared to a standard diagnostic method (Menzies algorithm).Methods The databases of two referral centres were retrospectively evaluated to retrieve dermoscopic images of amelanotic/hypomelanotic skin lesions. Two experts in dermoscopy, blinded for the final diagnosis and for clinical and demographic information, evaluated separately dermoscopic pictures of 1000 lesions according to the Menzies score and to the prevalent criterion method.Results According to the high sensitivity model of the Menzies score, 129 (12.9%) lesions were considered as nonsuspicious (of which 16 were false negative) and 871 (87.1%) as suspicious (of which 212 were false positive), with 97.6% sensitivity and 34.8% specificity. According to the high specificity model, 370 (37%) lesions were evaluated as non-suspicious (of which 105 were false negative) and 630 (63%) as suspicious (of which 60 were false positive), with 84.4% sensitivity and 81.5% specificity. Concerning the prevalent criterion method, 316 (31.6%) lesions were evaluated as non-suspicious (of which 46 were false negative) and 684 (68.4) as suspicious (of which 55 were false positive), with 93.2% sensitivity and 83.1% specificity.Conclusions This study demonstrated that focusing on the prevalent dermoscopic features could allow to detect malignant pink tumours with similar sensitivity but higher specificity than using the conventional Menzies scoring system.These authors equally contributed to this work and share the first authorship.

Clinicopathological and dermoscopic features of amelanotic and hypomelanotic melanoma: a retrospective multicentric study

“…As reported above, the vascular pattern is of utmost importance in the diagnosis of AHM 4,31,37 . We confirmed the prevalence of linear looped, linear irregular, and dotted vessels in AHM.…”

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

“…In these cases, the differential diagnosis between melanoma and other benign or malignant skin lesions was challenging and frequently based on the presence of 1 prevalent dermoscopic criterion, mainly atypical and polymorphous vessels. This is in line with a recent study assessing the superiority of a method based on the prevalent dermoscopic criterion, compared with a combination of different criteria, in diagnosing pink tumors . In the diagnostic workflow, the clinical and dermoscopic aspects should always be integrated with historical data on a patient’s medical history.…”

Multiple Primary Melanoma: A Five-Year Prospective Single-Center Follow-Up Study of Two MC1R R/R Genotype Carriers

“…We retrieved thirty melanoma-specific dermoscopic structures from literature [23,36,38,45,[78][79][80][81][82][83][84][85][86]. The attending dermatologist selected up to six present melanoma-specific dermoscopic clues for each case (58 SPMs).…”