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JOURNAL ARTICLE

Accuracy of dermatoscopy for the diagnosis of nonpigmented cancers of the skin

Christoph Sinz, Philipp Tschandl, Cliff Rosendahl, Bengu Nisa Akay, Giuseppe Argenziano, Andreas Blum, Ralph P Braun, Horacio Cabo, Jean-Yves Gourhant, Juergen Kreusch, Aimilios Lallas, Jan Lapins, Ashfaq A Marghoob, Scott W Menzies, John Paoli, Harold S Rabinovitz, Christoph Rinner, Alon Scope, H Peter Soyer, Luc Thomas, Iris Zalaudek, Harald Kittler
Journal of the American Academy of Dermatology 2017, 77 (6): 1100-1109
28941871

BACKGROUND: Nonpigmented skin cancer is common, and diagnosis with the unaided eye is error prone.

OBJECTIVE: To investigate whether dermatoscopy improves the diagnostic accuracy for nonpigmented (amelanotic) cutaneous neoplasms.

METHODS: We collected a sample of 2072 benign and malignant neoplastic lesions and inflammatory conditions and presented close-up images taken with and without dermatoscopy to 95 examiners with different levels of experience.

RESULTS: The area under the curve was significantly higher with than without dermatoscopy (0.68 vs 0.64, P < .001). Among 51 possible diagnoses, the correct diagnosis was selected in 33.1% of cases with and 26.4% of cases without dermatoscopy (P < .001). For experts, the frequencies of correct specific diagnoses of a malignant lesion improved from 40.2% without to 51.3% with dermatoscopy. For all malignant neoplasms combined, the frequencies of appropriate management strategies increased from 78.1% without to 82.5% with dermatoscopy.

LIMITATIONS: The study deviated from a real-life clinical setting and was potentially affected by verification and selection bias.

CONCLUSIONS: Dermatoscopy improves the diagnosis and management of nonpigmented skin cancer and should be used as an adjunct to examination with the unaided eye.

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