title: Objective follow-up of atypical melanocytic skin lesions: a retrospective study.
abstract: Various authors have suggested that information from longitudinal observation (follow-up) of dynamic changes in atypical melanocytic pigmented skin lesions (MPSL) could enable identification of early malignant melanoma escaping initial observation due to an absence of specific clinical and dermoscopic features. The aim of our retrospective study was to determine the existence of numerical variables regarding changes in MPSL that could be useful to differentiate early melanomas and atypical nevi. The study was carried out in two Italian dermatology Centres. Digital dermoscopy analyzers (DB-Mips System) were used to evaluate dermoscopic images of 94 equivocal pigmented skin lesions under observation for 6-12 months and then excised because of changes across time (29 melanomas and 65 nevi). The analyzer evaluates 49 parameters grouped into four categories: geometries, colours, textures and islands of colour. The ROC curve designed on the 49 digital dermoscopy analysis parameters showed good accuracy. At sensitivity (SE) = specificity (SP), it correctly classified 89.3% of cases. When objective pigmented skin lesion parameters were considered together with their objective changes over 6-12 months, a decisive increase in discrimination capacity was obtained. At SE = SP accuracy was 96.3%. Analysis of the parameters of our model and statistical analysis enabled us to interpret/identify the most significant factors of modification and differentiation of lesions, providing quantitative insights into the diagnosis of equivocal MPSL and demonstrating the utility of objective/numerical follow-up.
authors.affiliation: Department of Clinical Medicine and Immunological Science, Policlinico "Le Scotte", Siena, Italy. rubegni@unisi.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Rubegni
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cevenini
authors.forename: Marco
authors.initials: M
authors.lastname: Burroni
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bono
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Biagioli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Risulo
authors.forename: Niccolò
authors.initials: N
authors.lastname: Nami
authors.forename: Roberto
authors.initials: R
authors.lastname: Perotti
authors.forename: Clelia
authors.initials: C
authors.lastname: Miracco
authors.forename: Michele
authors.initials: M
authors.lastname: Fimiani
mesh_terms: D000328:Adult; D046169:Dermoscopy; D003937:Diagnosis, Differential; D004416:Dysplastic Nevus Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology