A new dermoscopic algorithm for the differential diagnosis of facial lentigo maligna and pigmented actinic keratosis

Ketty Peris, Luca Neri, Alessandro Di Stefani, Valeria Coco, Maria Concetta Fargnoli, Tamara Micantonio, Caterina Longo, Ambra Antonini, Giuseppe Argenziano

Risultato della ricerca: Contributo in rivistaArticolo in rivista

9 Citazioni (Scopus)

Abstract

The clinical and dermoscopic diagnosis of facial lentigo maligna (LM) and pigmented actinic keratosis (PAK) remains challenging, particularly at the early disease stages. To identify dermoscopic criteria that might be useful to differentiate LM from PAK, and to elaborate and validate an automated diagnostic algorithm for facial LM/PAK. We performed a retrospective multicentre study to evaluate dermoscopic images of histologically-proven LM and PAK, and assess previously described dermoscopic criteria. In the first part of the study, 61 cases of LM and 74 PAK were examined and a parsimonious algorithm was elaborated using stepwise discriminant analysis. The following eight dermoscopic criteria achieved the greatest discriminative power: (1) light brown colour; (2) a structureless zone, varying in colour from brown to brown/tan, to black; (3) in-focus, discontinuous brown lines; (4) incomplete brown or grey circles; (5) a structureless brown or black zone, obscuring the hair follicles; (6) a brown (tan), eccentric, structureless zone; (7) a blue structureless zone; and (8) scales. The newly developed algorithm was subsequently validated using an additional series of 110 LM and 75 PAK cases. Diagnostic accuracy was 86.5% (κ: 0.73, 95% CI: 0.63-0.83). For the diagnosis of LM vs PAK, sensitivity was 82.7% (95% CI: 75.7-89.8%), specificity was 92.0% (95% CI: 85.9-98.1%), positive predictive value was 93.8% (95% CI: 89.0-98.6%), and negative predictive value was 78.4% (95% CI: 68.4-86.5%). This algorithm may represent an additional tool for clinicians to distinguish between facial LM and PAK.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaEuropean Journal of Dermatology
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • dermoscopic algorithm
  • dermoscopy
  • lentigo maligna
  • lentigo maligna melanoma
  • pigmented actinic keratosis

Fingerprint Entra nei temi di ricerca di 'A new dermoscopic algorithm for the differential diagnosis of facial lentigo maligna and pigmented actinic keratosis'. Insieme formano una fingerprint unica.

Cita questo