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 ThomasIris Zalaudek, Harald Kittler

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1100-1109
Number of pages10
JournalJournal of the American Academy of Dermatology
Issue number6
StatePublished - Dec 2017
Externally publishedYes


  • dermatoscopy
  • dermoscopy
  • diagnosis
  • keratinocytic skin cancer
  • melanoma
  • nonpigmented skin cancer

ASJC Scopus subject areas

  • Dermatology


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