title: Impact of digital dermoscopy analysis on the decision to follow up or to excise a pigmented skin lesion: a multicentre study.
abstract: BACKGROUND
  The quality of early malignant melanoma (MM) diagnosis is dependent on the experience of dermatologists, tools like dermoscopy and histopathology, and awareness and education of the studied population. Does a higher rate of excision of pigmented skin lesions (PSL) increase the rate of detected melanomas?
  
  
  METHODS
  The DB-MIPS objective tool, able to evaluate mathematical defined variables, has been used to verify the variability of measurements among PSL stored by five different centres located in Italy, Switzerland, and Germany.
  
  
  RESULTS
  The objective analysis showed low differences in terms of moles' features among the different groups, arguing for robustness of the dermatological patient's PSL inspection. Differences in terms of false positives and predictive positive values have been detected. The tendency to follow up a lesion was proportional to the percentage of thin MM (<0.75 mm tumour thickness), while the interventism was proportional to the percentage of dysplastic moles. Similar percentage of thin melanoma has been observed in all the centres, indicating a standardization in early diagnosing among experienced dermatologists. The main difference among the centres was their mode of action, i.e. to follow up or remove suspicious PSL.
  
  
  CONCLUSIONS
  Interventism depends neither on the geographic site nor on the features of the observed moles. Higher removal rates do not correspond to higher MM detections: this means that an in-depth knowledge of melanoma patterns is required and follow-up of suspicious moles is highly suggested.
authors: Department of Dermatology, Section of Dermatology, University of Siena, Siena, Italy.
authors: Marco
authors: M
authors: Burroni
authors: Uwe
authors: U
authors: Wollina
authors: Rocco
authors: R
authors: Torricelli
authors: Stefano
authors: S
authors: Gilardi
authors: Giordana
authors: G
authors: Dell'Eva
authors: Cathrine
authors: C
authors: Helm
authors: Wolfgang
authors: W
authors: Bardey
authors: Niccolò
authors: N
authors: Nami
authors: Franco
authors: F
authors: Nobile
authors: Massimo
authors: M
authors: Ceccarini
authors: Adriano
authors: A
authors: Pomponi
authors: Biondi
authors: B
authors: Alessandro
authors: Pietro
authors: P
authors: Rubegni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D046169:Dermoscopy / Q000379:methods* / Q000592:standards; D004416:Dysplastic Nevus Syndrome / Q000473:pathology / Q000601:surgery; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000592:standards; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009508:Nevus, Pigmented / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult