OBJECTIVE: To measure and compare the accuracy of 4 different clinical methods in the diagnosis of melanoma in situ of the nail matrix among dermatologists with different levels of clinical experience. DESIGN: Twelve cases of melanonychias (5 melanomas and 7 nonmelanomas) were presented following 4 successive steps: (1) clinical evaluation, (2) evaluation according to the ABCDEF rule, (3) dermoscopy of the nail plate, and (4) intraoperative dermoscopy. At each step, the dermatologists were asked to decide if the lesion was a melanoma. SETTING: The test was administered at 2 dermatological meetings in 2008. PARTICIPANTS: A total of 152 dermatologists, including 11 nail experts, 53 senior dermatologists, and 88 junior dermatologists. MAIN OUTCOME MEASURES: The answers were evaluated as percentage of right answers for each diagnostic step according to the different grade of expertise. Differences among the percentage of right answers in the different steps were evaluated with the z test at a 5% level of significance. The agreement was investigated using Cohen kappa statistic. RESULTS: The only method that statistically influenced the correct diagnosis for each category (experts, seniors, and juniors) was intraoperative dermoscopy (z test; P < .05). Cohen kappa statistic showed a moderate interobserver agreement. CONCLUSIONS: Overall accuracy of dermatologists in the diagnosis of nail matrix melanoma in situ is low because the percentages of physicians who indicated the correct diagnosis during each of the first 3 clinical steps of the test ranged from 46% to 55%. The level of expertise did not statistically influence the correct diagnosis.
OBJECTIVE: To measure and compare the accuracy of 4 different clinical methods in the diagnosis of melanoma in situ of the nail matrix among dermatologists with different levels of clinical experience. DESIGN: Twelve cases of melanonychias (5 melanomas and 7 nonmelanomas) were presented following 4 successive steps: (1) clinical evaluation, (2) evaluation according to the ABCDEF rule, (3) dermoscopy of the nail plate, and (4) intraoperative dermoscopy. At each step, the dermatologists were asked to decide if the lesion was a melanoma. SETTING: The test was administered at 2 dermatological meetings in 2008. PARTICIPANTS: A total of 152 dermatologists, including 11 nail experts, 53 senior dermatologists, and 88 junior dermatologists. MAIN OUTCOME MEASURES: The answers were evaluated as percentage of right answers for each diagnostic step according to the different grade of expertise. Differences among the percentage of right answers in the different steps were evaluated with the z test at a 5% level of significance. The agreement was investigated using Cohen kappa statistic. RESULTS: The only method that statistically influenced the correct diagnosis for each category (experts, seniors, and juniors) was intraoperative dermoscopy (z test; P < .05). Cohen kappa statistic showed a moderate interobserver agreement. CONCLUSIONS: Overall accuracy of dermatologists in the diagnosis of nail matrix melanoma in situ is low because the percentages of physicians who indicated the correct diagnosis during each of the first 3 clinical steps of the test ranged from 46% to 55%. The level of expertise did not statistically influence the correct diagnosis.
Authors: Luiz Guilherme Martins Castro; Maria Cristina Messina; Walter Loureiro; Ricardo Silvestre Macarenco; João Pedreira Duprat Neto; Thais Helena Bello Di Giacomo; Flávia Vasques Bittencourt; Renato Marchiori Bakos; Sérgio Schrader Serpa; Hamilton Ometto Stolf; Gabriel Gontijo Journal: An Bras Dermatol Date: 2015 Nov-Dec Impact factor: 1.896
Authors: Nilton Di Chiacchio; Walter Refkalefsky Loureiro; Nilceo Schwery Michalany; Felipe Veiga Kezam Gabriel Journal: Dermatol Res Pract Date: 2012-03-14
Authors: Jacqueline Dinnes; Jonathan J Deeks; Naomi Chuchu; Rubeta N Matin; Kai Yuen Wong; Roger Benjamin Aldridge; Alana Durack; Abha Gulati; Sue Ann Chan; Louise Johnston; Susan E Bayliss; Jo Leonardi-Bee; Yemisi Takwoingi; Clare Davenport; Colette O'Sullivan; Hamid Tehrani; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Jacqueline Dinnes; Jonathan J Deeks; Naomi Chuchu; Lavinia Ferrante di Ruffano; Rubeta N Matin; David R Thomson; Kai Yuen Wong; Roger Benjamin Aldridge; Rachel Abbott; Monica Fawzy; Susan E Bayliss; Matthew J Grainge; Yemisi Takwoingi; Clare Davenport; Kathie Godfrey; Fiona M Walter; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Jacqueline Dinnes; Jonathan J Deeks; Matthew J Grainge; Naomi Chuchu; Lavinia Ferrante di Ruffano; Rubeta N Matin; David R Thomson; Kai Yuen Wong; Roger Benjamin Aldridge; Rachel Abbott; Monica Fawzy; Susan E Bayliss; Yemisi Takwoingi; Clare Davenport; Kathie Godfrey; Fiona M Walter; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Ana Maria Carreño; Sílvia Rocha Nakajima; Silmara N Pennini; Renato Candido Junior; Antonio Pedro Mendes Schettini Journal: An Bras Dermatol Date: 2013 Mar-Apr Impact factor: 1.896