title: Dermoscopy structures as predictors of sentinel lymph node positivity in cutaneous melanoma.
abstract: BACKGROUND
  Histological features such as Breslow thickness, ulceration and mitosis are the main criteria to guide sentinel lymph node biopsy (SLNB) in melanoma. Dermoscopy may add complementary information to these criteria.
  
  
  OBJECTIVE
  To evaluate the correlation between dermoscopy structures and SLNB positivity.
  
  
  METHODS
  Retrospective analysis of 123 consecutive melanomas with Breslow thickness > 0·75 mm, SLNB performed during follow-up and dermoscopic images.
  
  
  RESULTS
  Men were more likely to have a positive SLNB. The presence of ulceration and blotch and the absence of a pigmented network in dermoscopy correlated with positive SLNB. Histological ulceration also correlated with positive SLNB. A dermoscopy SCORE predicted SLN status with a sensitivity of 96·3% and a specificity of 30·2%. When sex and Breslow thickness were added (SCOREBRESEX), the sensitivity remained at 96·3% but the specificity increased to 52·1%. This study is limited by the number of patients and was performed in only one institution.
  
  
  CONCLUSIONS
  Dermoscopy allowed a more precise prediction of SLN status. If a combined SCOREBRESEX was used to select patients for SLNB, 41·5% of procedures might be avoided.
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.|Universidad CES, Medellín, Colombia.
authors.forename: T
authors.initials: T
authors.lastname: González-Álvarez
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.|Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Carrera
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bennassar
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Vilalta
authors.affiliation: Melanoma Unit, Surgery Service, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Rull
authors.affiliation: Melanoma Unit, Pathology Service, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.|Medicine Department, Universitat de Barcelona, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Alos
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Palou
authors.affiliation: Melanoma Unit, Nuclear Medicine Service, Unit, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Vidal-Sicart
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.|Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Malvehy
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.|Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain.|Medicine Department, Universitat de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Puig
mesh_terms: D046169:Dermoscopy / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*