Clinical and dermatoscopic diagnosis of small pigmented skin lesions.
Small pigmented skin lesions represent a new challenge for all physicians devoted to the early diagnosis of melanoma. The purpose of this prospective study was to establish the diagnostic value of the clinical and the dermatoscopic examinations in a population of 157 consecutive patients with 161 small (< or = 6 mm) pigmented lesions, recruited in a short time. Of these 161 lesions, 13 were thin melanomas (median thickness 0.49 mm). In this population, clinical evaluation produced a diagnostic sensitivity of 77% and a specificity of 74%. Dermatoscopy resulted in a sensitivity of 77% and in a specificity of 72%. Combining clinical and dermatoscopic evaluations all the melanomas were preoperatively recognised. The results of the present study stress the complementary role of clinical and dermatoscopic examinations. In particular, clinical evaluation remains of utmost importance in diagnosing melanoma. This concept must be stressed in the education and training of young dermatologists.
Bono
Aldo
A
Melanoma Unit, Istituto Nazionale per lo studio e la cura dei Tumori, Via Venezian 1, 20133, Milan, Italy. aldo.bono@istitutotumori.mi.it
Bartoli
Cesare
C
Baldi
Marzia
M
Tomatis
Stefano
S
Bifulco
Carlo
C
Santinami
Mario
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003880:Dermatology / Q000295:instrumentation* / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*