title: Dermoscopy and digital dermoscopy analysis of palmoplantar 'equivocal' pigmented skin lesions in Caucasians.
abstract: OBJECTIVE
  The diagnosis of palmoplantar melanoma is often delayed and misdiagnosis is common, due to frequently unusual clinical presentation. We used a digital dermoscopy analyzer with a series of palmoplantar pigmented skin lesions (PP-PSL), and we compared sensitivity, specificity and diagnostic accuracy obtained with digital dermoscopy analysis (DDA) and classical dermoscopy.
  
  
  METHODS
  Digital dermoscopy images of 107 PP-PSL were retrospectively obtained from the database of images of 3 Italian centers. The lesions (25 melanomas and 82 nevi) were all removed because of the presence of clinical and/or dermoscopic suspicious features. All digital images were analyzed using appropriate algorithms, and the diagnostic accuracy of the model was calculated. For comparison, dermoscopic images were clinically evaluated by two dermatologists and the Cohen ĸ concordance with DDA was calculated.
  
  
  RESULTS
  The stepwise logistic regression analysis selected only 5 parameters out of 49. The logistic model achieved a sensitivity of 96% and a specificity of 87.8%. The Cohen ĸ concordance, evaluated by the Landis and Koch scale, supplied a substantial agreement between dermoscopy and DDA.
  
  
  CONCLUSIONS
  DDA might be a useful diagnostic instrument in the evaluation of preselected PP-PSL. However, these findings should be confirmed in a formal clinical trial.
authors.affiliation: Dermatology Section, Department of Clinical Medicine and Immunological Science, University of Siena, Siena, Italy. rubegni@unisi.it
authors.forename: P
authors.initials: P
authors.lastname: Rubegni
authors.forename: G
authors.initials: G
authors.lastname: Cevenini
authors.forename: N
authors.initials: N
authors.lastname: Nami
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
authors.forename: T
authors.initials: T
authors.lastname: Saida
authors.forename: M
authors.initials: M
authors.lastname: Burroni
authors.forename: R
authors.initials: R
authors.lastname: Bono
authors.forename: P
authors.initials: P
authors.lastname: Quaglino
authors.forename: P
authors.initials: P
authors.lastname: Barbini
authors.forename: C
authors.initials: C
authors.lastname: Miracco
authors.forename: A
authors.initials: A
authors.lastname: Lamberti
authors.forename: M
authors.initials: M
authors.lastname: Fimiani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D046169:Dermoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D009506:Nevus / Q000175:diagnosis* / Q000208:ethnology; D010859:Pigmentation Disorders / Q000175:diagnosis* / Q000208:ethnology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D044465:White People; D055815:Young Adult