Christoph Sinz1, Philipp Tschandl1, Cliff Rosendahl2, Bengu Nisa Akay3, Giuseppe Argenziano4, Andreas Blum5, Ralph P Braun6, Horacio Cabo7, Jean-Yves Gourhant8, Juergen Kreusch9, Aimilios Lallas10, Jan Lapins11, Ashfaq A Marghoob12, Scott W Menzies13, John Paoli14, Harold S Rabinovitz15, Christoph Rinner16, Alon Scope17, H Peter Soyer18, Luc Thomas19, Iris Zalaudek20, Harald Kittler21. 1. Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria. 2. Faculty of Medicine, The University of Queensland, Brisbane, Australia; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Dermatology, Ankara University Faculty of Medicine, Ankara, Turkey. 4. Dermatology Unit, University of Campania, Naples, Italy. 5. Public, Private and Teaching Practice of Dermatology, Konstanz, Germany. 6. Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. 7. Department of Dermatology, Instituto de Investigaciones Médicas "A. Lanari," University of Buenos Aires, Buenos Aires, Argentina. 8. Centre de Dermatologie, Nemours, France. 9. Private Dermatology Practice, Lübeck, Germany. 10. First Department of Dermatology, Aristotle University, Thessaloniki, Greece. 11. Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden. 12. Memorial Sloan Kettering Cancer Center, Hauppauge, New York. 13. Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, and Discipline of Dermatology, University of Sydney, Sydney, Australia. 14. Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 15. Skin and Cancer Associates, Plantation, Florida. 16. Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria. 17. Department of Dermatology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 18. Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia. 19. Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon 1 University, Lyons Cancer Research Center, Lyon, France. 20. Department of Dermatology, Medical University of Graz, Graz, Austria. 21. Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria. Electronic address: harald.kittler@meduniwien.ac.at.
Abstract
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.
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.
Authors: Andreas Blum; Friedrich A Bahmer; Jürgen Bauer; Ralph P Braun; Brigitte Coras-Stepanek; Teresa Deinlein; Thomas Eigentler; Christine Fink; Claus Garbe; Holger A Haenssle; Rainer Hofmann-Wellenhof; Harald Kittler; Jürgen Kreusch; Hubert Pehamberger; Hans Schulz; H Peter Soyer; Wilhelm Stolz; Philipp Tschandl; Iris Zalaudek Journal: Hautarzt Date: 2019-11 Impact factor: 0.751
Authors: Cristian Navarrete-Dechent; Konstantinos Liopyris; Ayelet Rishpon; Nadeem G Marghoob; Miguel Cordova; Stephen W Dusza; Aditi Sahu; Kivanc Kose; Margaret Oliviero; Harold Rabinovitz; Klaus J Busam; Michael A Marchetti; Chih-Chan J Chen; Ashfaq A Marghoob Journal: JAMA Dermatol Date: 2020-08-01 Impact factor: 10.282
Authors: Philipp Tschandl; Cliff Rosendahl; Bengu Nisa Akay; Giuseppe Argenziano; Andreas Blum; Ralph P Braun; Horacio Cabo; Jean-Yves Gourhant; Jürgen Kreusch; Aimilios Lallas; Jan Lapins; Ashfaq Marghoob; Scott Menzies; Nina Maria Neuber; John Paoli; Harold S Rabinovitz; Christoph Rinner; Alon Scope; H Peter Soyer; Christoph Sinz; Luc Thomas; Iris Zalaudek; Harald Kittler Journal: JAMA Dermatol Date: 2019-01-01 Impact factor: 10.282