title: Micro-melanoma detection: a clinical study on 206 consecutive cases of pigmented skin lesions with a diameter < or = 3 mm.
abstract: BACKGROUND
  Very small pigmented lesions may represent an important diagnostic challenge to the clinician.
  
  
  OBJECTIVE
  The aim of the present study was to establish the diagnostic value, in terms of sensitivity and specificity, of both clinical and dermoscopic examinations in a population of patients with unselected consecutive pigmented lesions with a maximum clinical diameter of 3 mm.
  
  
  METHODS
  Two hundred and four consecutive patients bearing 206 pigmented skin lesions with a maximum diameter of 3 mm were seen and operated on. Twenty-three of these lesions were melanomas. Each lesion was subjected to both clinical and dermoscopic evaluation before surgery. The results were expressed in terms of sensitivity and specificity of both kinds of evaluation.
  
  
  RESULTS
  Clinical evaluation produced a diagnostic sensitivity of 43% and a specificity of 91%. Dermoscopy resulted in a sensitivity of 83% and in a specificity of 69%. The comparison between the sensitivity values of the two diagnostic methods showed a significant difference (P < 0.01). A high value of significance was also obtained comparing the respective specificity values (P < 0.001).
  
  
  CONCLUSIONS
  Detection of very small melanomas is feasible by accurate visual inspection. Dermoscopy appears to be an important aid to diagnosis, provided that physicians are aware of this type of lesion and maintain the index of suspicion at a high level.
authors.affiliation: Melanoma and Sarcoma Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133 Milan, Italy. aldo.bono@istitutotumori.mi.it
authors.forename: A
authors.initials: A
authors.lastname: Bono
authors.forename: E
authors.initials: E
authors.lastname: Tolomio
authors.forename: S
authors.initials: S
authors.lastname: Trincone
authors.forename: C
authors.initials: C
authors.lastname: Bartoli
authors.forename: S
authors.initials: S
authors.lastname: Tomatis
authors.forename: A
authors.initials: A
authors.lastname: Carbone
authors.forename: M
authors.initials: M
authors.lastname: Santinami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D046169:Dermoscopy; D003937:Diagnosis, Differential; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology*