TY - JOUR
T1 - Dermoscopic evaluation of amelanotic and hypomelanotic melanoma
AU - Menzies, Scott W.
AU - Kreusch, Juergen
AU - Byth, Karen
AU - Pizzichetta, Maria A.
AU - Marghoob, Ashfaq
AU - Braun, Ralph
AU - Malvehy, Josep
AU - Puig, Susana
AU - Argenziano, Giuseppe
AU - Zalaudek, Iris
AU - Rabinovitz, Harold S.
AU - Oliviero, Margaret
AU - Cabo, Horacio
AU - Ahlgrimm-Siess, Verena
AU - Avramidis, Michelle
AU - Guitera, Pascale
AU - Soyer, H. Peter
AU - Ghigliotti, Giovanni
AU - Tanaka, Masaru
AU - Perusquia, Ana M.
AU - Pagnanelli, Gianluca
AU - Bono, Riccardo
AU - Thomas, Luc
AU - Pellacani, Giovanni
AU - Langford, David
AU - Piccolo, Domenico
AU - Terstappen, Karin
AU - Stanganelli, Ignazio
AU - Llambrich, Alex
AU - Johr, Robert
PY - 2008/9
Y1 - 2008/9
N2 - Objective: To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma. Design: A total of 105 melanomas (median Breslow thickness, 0.76 mm), 170 benign melanocytic lesions, and 222 nonmelanocytic lesions lacking significant pigment (amelanotic, partially pigmented, and light colored) were imaged using glass-plate dermoscopy devices and scored for 99 dermoscopic features. Diagnostic models were derived from and tested on independent randomly selected lesions. Setting: Predominantly hospital-based clinics from 5 continents. Main Outcome Measures: Sensitivity, specificity, and odds ratios for individual features and models for the diagnosis of melanoma and malignancy. Results: The most significant negative predictors of melanoma were having multiple (>3) milialike cysts (odds ratio, 0.09; 95% confidence interval, 0.01-0.64), comma vessels with a regular distribution (0.10; 0.01-0.70), comma vessels as the predominant vessel type (0.16; 0.05-0.52), symmetrical pigmentation pattern (0.18; 0.09-0.39), irregular blue-gray globules (0.20; 0.05-0.87), and multiple blue-gray globules (0.28; 0.10-0.81). The most significant positive predictors were having a blue-white veil (odds ratio,13; 95% confidence interval, 3.9-40.0), scarlike depigmentation (4.4; 2.4-8.0), multiple blue-gray dots (3.5; 1.9-6.4), irregularly shaped depigmentation (3.3; 2.0-5.3), irregular brown dots/globules (3.2; 1.8-5.6), 5 to 6 colors (3.2; 1.6-6.3), and predominant central vessels (3.1; 1.6-6.0). A simple model distinguishing melanomas from all nonmelanomas had a sensitivity of 70% and a specificity of 56% in the test set. A model distinguishing all malignant lesions from benign lesions had a sensitivity of 96% and a specificity of 37%. Conclusion: Although the diagnostic accuracy of dermoscopy for melanoma lacking significant pigment is inferior to that of more pigmented lesions, features distinguishing the former from benign lesions can be visualized on dermoscopic evaluation.
AB - Objective: To determine the predictive dermoscopic features of amelanotic and hypomelanotic melanoma. Design: A total of 105 melanomas (median Breslow thickness, 0.76 mm), 170 benign melanocytic lesions, and 222 nonmelanocytic lesions lacking significant pigment (amelanotic, partially pigmented, and light colored) were imaged using glass-plate dermoscopy devices and scored for 99 dermoscopic features. Diagnostic models were derived from and tested on independent randomly selected lesions. Setting: Predominantly hospital-based clinics from 5 continents. Main Outcome Measures: Sensitivity, specificity, and odds ratios for individual features and models for the diagnosis of melanoma and malignancy. Results: The most significant negative predictors of melanoma were having multiple (>3) milialike cysts (odds ratio, 0.09; 95% confidence interval, 0.01-0.64), comma vessels with a regular distribution (0.10; 0.01-0.70), comma vessels as the predominant vessel type (0.16; 0.05-0.52), symmetrical pigmentation pattern (0.18; 0.09-0.39), irregular blue-gray globules (0.20; 0.05-0.87), and multiple blue-gray globules (0.28; 0.10-0.81). The most significant positive predictors were having a blue-white veil (odds ratio,13; 95% confidence interval, 3.9-40.0), scarlike depigmentation (4.4; 2.4-8.0), multiple blue-gray dots (3.5; 1.9-6.4), irregularly shaped depigmentation (3.3; 2.0-5.3), irregular brown dots/globules (3.2; 1.8-5.6), 5 to 6 colors (3.2; 1.6-6.3), and predominant central vessels (3.1; 1.6-6.0). A simple model distinguishing melanomas from all nonmelanomas had a sensitivity of 70% and a specificity of 56% in the test set. A model distinguishing all malignant lesions from benign lesions had a sensitivity of 96% and a specificity of 37%. Conclusion: Although the diagnostic accuracy of dermoscopy for melanoma lacking significant pigment is inferior to that of more pigmented lesions, features distinguishing the former from benign lesions can be visualized on dermoscopic evaluation.
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U2 - 10.1001/archderm.144.9.1120
DO - 10.1001/archderm.144.9.1120
M3 - Article
C2 - 18794455
AN - SCOPUS:51949101914
SN - 2168-6068
VL - 144
SP - 1120
EP - 1127
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 9
ER -