Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet.
BACKGROUND
There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions.


OBJECTIVE
The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms.


METHODS
Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experienced dermoscopists using a 2-step diagnostic procedure. The first-step algorithm distinguished melanocytic versus nonmelanocytic lesions. The second step in the diagnostic procedure used 4 algorithms (pattern analysis, ABCD rule, Menzies method, and 7-point checklist) to distinguish melanoma versus benign melanocytic lesions. kappa Values, log odds ratios, sensitivity, specificity, and positive likelihood ratios were estimated for all diagnostic algorithms and dermoscopic features.


RESULTS
Interobserver agreement was fair to good for all diagnostic methods, but it was poor for the majority of dermoscopic criteria. Intraobserver agreement was good to excellent for all algorithms and features considered. Pattern analysis allowed the best diagnostic performance (positive likelihood ratio: 5.1), whereas alternative algorithms revealed comparable sensitivity but less specificity. Interobserver agreement on management decisions made by dermoscopy was fairly good (mean kappa value: 0.53).


CONCLUSIONS
The virtual Consensus Net Meeting on Dermoscopy represents a valid tool for better standardization of the dermoscopic terminology and, moreover, opens up a new territory for diagnosing and managing pigmented skin lesions.
Argenziano
Giuseppe
G
Department of Dermatology, Second University of Naples, Italy.
Soyer
H Peter
HP
Chimenti
Sergio
S
Talamini
Renato
R
Corona
Rosamaria
R
Sera
Francesco
F
Binder
Michael
M
Cerroni
Lorenzo
L
De Rosa
Gaetano
G
Ferrara
Gerardo
G
Hofmann-Wellenhof
Rainer
R
Landthaler
Michael
M
Menzies
Scott W
SW
Pehamberger
Hubert
H
Piccolo
Domenico
D
Rabinovitz
Harold S
HS
Schiffner
Roman
R
Staibano
Stefania
S
Stolz
Wilhelm
W
Bartenjev
Igor
I
Blum
Andreas
A
Braun
Ralph
R
Cabo
Horacio
H
Carli
Paolo
P
De Giorgi
Vincenzo
V
Fleming
Matthew G
MG
Grichnik
James M
JM
Grin
Caron M
CM
Halpern
Allan C
AC
Johr
Robert
R
Katz
Brian
B
Kenet
Robert O
RO
Kittler
Harald
H
Kreusch
Jürgen
J
Malvehy
Josep
J
Mazzocchetti
Giampiero
G
Oliviero
Margaret
M
Ozdemir
Fezal
F
Peris
Ketty
K
Perotti
Roberto
R
Perusquia
Ana
A
Pizzichetta
Maria Antonietta
MA
Puig
Susana
S
Rao
Babar
B
Rubegni
Pietro
P
Saida
Toshiaki
T
Scalvenzi
Massimiliano
M
Seidenari
Stefania
S
Stanganelli
Ignazio
I
Tanaka
Masaru
M
Westerhoff
Karin
K
Wolf
Ingrid H
IH
Braun-Falco
Otto
O
Kerl
Helmut
H
Nishikawa
Takeji
T
Wolff
Klaus
K
Kopf
Alfred W
AW
D000465:Algorithms; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D020407:Internet; D008545:Melanoma / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D008853:Microscopy / Q000379:methods* / Q000592:standards; D010781:Photography; D017410:Practice Guidelines as Topic; D012016:Reference Values; D012680:Sensitivity and Specificity; D012871:Skin Diseases / Q000175:diagnosis / Q000473:pathology; D012878:Skin Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D012880:Skin Pigmentation; D009626:Terminology as Topic