Dermoscopy of Solitary Angiokeratomas : A Morphological Study

Zaballos, Pedro, Daufí, Cinta, Puig, Susana, Argenziano, Gusieppe, Moreno-Ramírez, David, Cabo, Horacio, Marghoob, Ashfaq A., Llambrich, Alex, Zalaudek, Iris and Malvehy, Josep (2007) Dermoscopy of Solitary Angiokeratomas : A Morphological Study. Archives of Dermatology, 143 3: 318-325. doi:10.1001/archderm.143.3.318

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Author Zaballos, Pedro
Daufí, Cinta
Puig, Susana
Argenziano, Gusieppe
Moreno-Ramírez, David
Cabo, Horacio
Marghoob, Ashfaq A.
Llambrich, Alex
Zalaudek, Iris
Malvehy, Josep
Title Dermoscopy of Solitary Angiokeratomas : A Morphological Study
Journal name Archives of Dermatology   Check publisher's open access policy
ISSN 0003-987X
Publication date 2007-03-01
Sub-type Article (original research)
DOI 10.1001/archderm.143.3.318
Open Access Status File (Publisher version)
Volume 143
Issue 3
Start page 318
End page 325
Total pages 8
Place of publication Chicago Ill
Publisher American Medical Association
Language eng
Subject 110304 Dermatology
Formatted abstract
Objectives To describe the dermoscopic structures and patterns associated with solitary angiokeratomas and to determine the sensitivity, specificity, positive predictive value, negative predictive value, and reproducibility of these dermoscopic features.

Design Multicenter retrospective study.

Setting University hospitals in Spain, Italy, Argentina, New York City, and Austria.

Patients There were 256 patients total, and 32 specimens each of solitary angiokeratomas, melanocytic nevi, Spitz-Reed nevi, malignant melanomas, pigmented basal cell carcinomas, dermatofibromas, seborrheic keratoses, and other vascular lesions (19 angiomas, 7 pyogenic granulomas, 3 spider nevi, 2 lymphangiomas, and 1 venous lake) were consecutively collected from the laboratories of 8 hospitals. Diagnoses of all patients' lesions were confirmed histopathologically.

Intervention Dermoscopic examination.

Main Outcome Measures The frequency, sensitivity, specificity, positive predictive value, negative predictive value, intraobserver agreement, and interobserver agreement of the different dermoscopic features associated with solitary angiokeratomas were calculated, and the differences were evaluated using the {chi}2 or Fisher exact test.

Results Six dermoscopic structures were evident in at least 50% of the solitary angiokeratomas: dark lacunae (94%), whitish veil (91%), erythema (69%), peripheral erythema (53%), red lacunae (53%), and hemorrhagic crusts (53%). Dark lacunae exhibited a sensitivity of 93.8% and a specificity of 99.1% (P<.001 for both), not being found in malignant melanomas or pigmented basal cell carcinomas. The positive predictive value was 93.8%, and the negative predictive value was 99.1%. The intraobserver agreement was perfect ({kappa}, 1.00), and the interobserver agreement was excellent ({kappa} range, 0.83-1.00) (P<.001 for both). Pattern 1, consisting of dark lacunae and whitish veil, exhibited a sensitivity of 84.4% and a specificity of 99.1% and was not found in malignant melanomas or pigmented basal cell carcinomas. The positive predictive value was 93.1%, the negative predictive value was 97.8%, the intraobserver agreement was perfect ({kappa}, 1.00), and the interobserver agreement was excellent ({kappa} range, 0.83-1.00) (P<.001 for all).

Conclusion Dermoscopy is helpful in improving the diagnostic accuracy of solitary angiokeratomas and allows the observer to differentiate them from other cutaneous tumors such as malignant melanomas and pigmented basal cell carcinomas.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Tue, 07 Apr 2009, 18:42:32 EST by Maryanne Watson on behalf of School of Medicine