Dataset Information

The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis.

ABSTRACT: Both colors and structures are considered important in the dermoscopic evaluation of skin lesions but their relative significance is unknown.To determine if diagnostic accuracy for common skin lesions differs between gray-scale and color dermoscopic images.A convenience sample of 40 skin lesions (8 nevi, 8 seborrheic keratoses, 7 basal cell carcinomas, 7 melanomas, 4 hemangiomas, 4 dermatofibromas, 2 squamous cell carcinomas [SCCs]) was selected and shown to attendees of a dermoscopy course (2014 Memorial Sloan Kettering Cancer Center dermoscopy course). Twenty lesions were shown only once, either in gray-scale (n?=?10) or color (n?=?10) (nonpaired). Twenty lesions were shown twice, once in gray-scale (n?=?20) and once in color (n?=?20) (paired). Participants provided their diagnosis and confidence level for each of the 60 images. Of the 261 attendees, 158 participated (60.5%) in the study. Most were attending physicians (n?=?76 [48.1%]). Most participants were practicing or training in dermatology (n?=?144 [91.1%]). The median (interquartile range) experience evaluating skin lesions and using dermoscopy of participants was 6 (13.5) and 2 (4.0) years, respectively.Diagnostic accuracy and confidence level of participants evaluating gray-scale and color images. Two separate analyses were performed: (1) an unpaired evaluation comparing gray-scale and color images shown either once or for the first time, and (2) a paired evaluation comparing pairs of gray-scale and color images of the same lesion.In univariate analysis of unpaired images, color images were less likely to be diagnosed correctly compared with gray-scale images (odds ratio [OR], 0.8; P?

SUBMITTER: Bajaj S

PROVIDER: S-EPMC5473029 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis.

Bajaj Shirin S Marchetti Michael A MA Navarrete-Dechent Cristian C Dusza Stephen W SW Kose Kivanc K Marghoob Ashfaq A AA

JAMA dermatology 20160601 6

<h4>Importance</h4>Both colors and structures are considered important in the dermoscopic evaluation of skin lesions but their relative significance is unknown.<h4>Objective</h4>To determine if diagnostic accuracy for common skin lesions differs between gray-scale and color dermoscopic images.<h4>Design, setting, and participants</h4>A convenience sample of 40 skin lesions (8 nevi, 8 seborrheic keratoses, 7 basal cell carcinomas, 7 melanomas, 4 hemangiomas, 4 dermatofibromas, 2 squamous cell car ...[more]

PMID: 27007917

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Project description:ImportanceIt is challenging to differentiate melanoma from melanocytic nevus on the volar skin in the absence of typical dermoscopic patterns.ObjectiveTo identify the frequency and clinical and dermoscopic characteristics of melanocytic lesions on the volar skin not displaying a parallel furrow pattern, lattice-like pattern, fibrillar pattern, or parallel ridge pattern on results of dermoscopy.Design, setting, and participantsIn this retrospective cohort study, a total of 504 melanocytic lesions on the volar skin were evaluated in the Shinshu University Hospital department of dermatology between January 1, 2000, and December 31, 2012. Dermoscopic images were independently assessed by 3 dermoscopists for the presence of established dermoscopic criteria. Statistical analysis was performed from October 1, 2017, to April 30, 2018.Main outcomes and measuresFrequency of dermoscopic criteria and corresponding clinical (patient age and size and location of lesion) and histopathologic features.ResultsOf 504 lesions, 110 (21.8%) (melanocytic nevus, 97; melanoma, 8; and equivocal melanocytic lesion, 5) from 108 patients (68 female and 40 male patients; mean age, 40.1 years [range, 1-86 years]) did not show a parallel furrow pattern, lattice-like pattern, fibrillar pattern, or parallel ridge pattern. Among them, the mean patient age was significantly higher for melanoma than for melanocytic nevus (65.3 vs 38.0 years; P < .001), as was mean maximum lesion diameter (11.8 vs 5.7 mm; P < .001). Melanomas and equivocal melanocytic lesions tended to be distributed on weight-bearing areas of the foot sole, such as the heel, while nevi were spread over non-weight-bearing regions. Dermoscopically, 95 melanocytic nevi (97.9%) were symmetrical in 1 or 2 axes while melanomas were not. A total of 91 melanocytic nevi (93.8%) had 1 or 2 colors per lesion, and 4 melanomas (50.0%) had more than 2 colors. Vascular structures were seen in 3 melanocytic nevi (3.1%) and 3 melanomas (37.5%). Blue-white structures were seen in 18 melanocytic nevi (18.6%) and 3 melanomas (37.5%). Dots and globules were seen in 22 melanocytic nevi (22.7%) and 4 melanomas (50.0%). Vascular structures, blue-white structures, and dots and globules were irregularly distributed in the melanomas. Ulcer, hyperkeratosis, and irregular streaks were observed only in melanomas.Conclusions and relevanceMore than one-fifth of melanocytic lesions on the volar skin did not display typical dermoscopic patterns. Asymmetry, numerous colors (≥3), and other melanoma-specific dermoscopic findings were more frequently observed for melanomas. Clinical information, including patient age and lesion size and location, was helpful in differentiating melanoma from melanocytic nevus. Further prospective clinical studies are warranted to clarify the diagnostic accuracy of dermoscopy combined with clinical information.

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Dataset Information

The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis.

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The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis.

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