Dermoscopic and histopathologic diagnosis of equivocal melanocytic skin lesions: An interdisciplinary study on 107 cases

Ferrara, Gerardo, Argenziano, Giuseppe, Soyer, H. Peter, Corona, Rosamaria, Sera, Francesco, Brunetti, Bruno, Cerroni, Lorenzo, Chimenti, Sergio, El Shabrawi-Caelen, Laila, Ferrari, Angela, Hofmann-Wellenhof, Rainer, Kaddu, Steven, Piccolo, Domenico, Scalvenzi, Massimiliano, Staibano, Stefania, Wolf, Ingrid H. and De Rosa, Gaetano (2002) Dermoscopic and histopathologic diagnosis of equivocal melanocytic skin lesions: An interdisciplinary study on 107 cases. Cancer, 95 5: 1094-1100. doi:10.1002/cncr.10768


Author Ferrara, Gerardo
Argenziano, Giuseppe
Soyer, H. Peter
Corona, Rosamaria
Sera, Francesco
Brunetti, Bruno
Cerroni, Lorenzo
Chimenti, Sergio
El Shabrawi-Caelen, Laila
Ferrari, Angela
Hofmann-Wellenhof, Rainer
Kaddu, Steven
Piccolo, Domenico
Scalvenzi, Massimiliano
Staibano, Stefania
Wolf, Ingrid H.
De Rosa, Gaetano
Title Dermoscopic and histopathologic diagnosis of equivocal melanocytic skin lesions: An interdisciplinary study on 107 cases
Journal name Cancer   Check publisher's open access policy
ISSN 0008-543X
1097-0142
Publication date 2002-09-01
Year available 2013
Sub-type Article (original research)
DOI 10.1002/cncr.10768
Open Access Status
Volume 95
Issue 5
Start page 1094
End page 1100
Total pages 7
Place of publication Hoboken, NJ, U.S.A.
Publisher Wiley
Language eng
Subject 110304 Dermatology
1103 Clinical Sciences
Abstract BACKGROUND. Dermoscopy (dermatoscopy, epiluminescence microscopy) is increasingly employed for the preoperative detection of cutaneous melanoma; dermoscopic features of pigmented skin lesions have been previously defined using histopathology as the key to the code. In a preliminary study on 10 cases evaluated by nine dermoscopists and nine histopathologists, the authors experienced that when at least two dermoscopists disagree in evaluating a melanocytic lesion, even histopathologic consultations may give equivocal results.
Formatted abstract
Background: Dermoscopy (dermatoscopy, epiluminescence microscopy) is increasingly employed for the preoperative detection of cutaneous melanoma; dermoscopic features of pigmented skin lesions have been previously defined using histopathology as the key to the code. In a preliminary study on 10 cases evaluated by nine dermoscopists and nine histopathologists, the authors experienced that when at least two dermoscopists disagree in evaluating a melanocytic lesion, even histopathologic consultations may give equivocal results.
Methods: One hundred seven melanocytic skin lesions, consecutively excised because of equivocal clinical and/or dermoscopic features, were retrospectively examined by eight dermoscopists and eight histopathologists; the diagnostic interobserver agreement was calculated by means of the Schouten k statistics. After histopathologic consultations, all 107 lesions underwent unblinded dermoscopic re-evaluation in order to find which dermoscopic features had given rise to histopathologic diagnostic difficulties.
Results: The interobserver ageement was good for both dermoscopy (k = 0.53) and histopathology (k = 0.74). Out of 48 cases evaluated by the dermoscopists in complete accordance, only 8 (16.7%) received at least one conflicting histopathologic diagnosis. Instead, among the remaining 59 cases with at least one disagreeing dermoscopic diagnosis, 21 (35.6%) received at least one disagreeing histopathologic diagnosis. The unblinded dermoscopic re-evaluation showed that five out of seven lesions with clear-cut regression structures were histopathologically controversial.
Conclusions: At least for selected and reasonably difficult lesions, a diagnostic discrepancy among formally trained dermoscopists seems to be predictive for a diagnostic disagreement among histopathologists. Lesions showing clear-cut regression structures are prone to give some histopathologic disagreement. Cancer 2002;95:1094-1100.
© 2002 American Cancer Society.
Keyword Dermoscopy
Dermatoscopy
Epiluminescence microscopy
Histopathology
Melanoma
Melanocytic skin lesions
Diagnosis
Interobserver agreement
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 44 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 49 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 25 Mar 2009, 22:43:10 EST by Ms Karen Naughton on behalf of Faculty Of Health Sciences