Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.

Non-invasive diagnosis of pink basal cell carcinoma: how much can we rely on dermoscopy and reflectance confocal microscopy? / Witkowski, A. M; Łudzik, J; TEIXEIRA DE CARVALHO, Nathalie; Ciardo, S; Longo, Caterina; DI NARDO, Antonio; Pellacani, Giovanni. - In: SKIN RESEARCH AND TECHNOLOGY. - ISSN 0909-752X. - ELETTRONICO. - 22:1(2016), pp. 230-237. [10.1111/srt.12254]

Non-invasive diagnosis of pink basal cell carcinoma: how much can we rely on dermoscopy and reflectance confocal microscopy?

TEIXEIRA DE CARVALHO, NATHALIE;LONGO, Caterina;DI NARDO, ANTONIO;PELLACANI, Giovanni
2016

Abstract

Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.
2016
4-set-2015
22
1
230
237
Non-invasive diagnosis of pink basal cell carcinoma: how much can we rely on dermoscopy and reflectance confocal microscopy? / Witkowski, A. M; Łudzik, J; TEIXEIRA DE CARVALHO, Nathalie; Ciardo, S; Longo, Caterina; DI NARDO, Antonio; Pellacani, Giovanni. - In: SKIN RESEARCH AND TECHNOLOGY. - ISSN 0909-752X. - ELETTRONICO. - 22:1(2016), pp. 230-237. [10.1111/srt.12254]
Witkowski, A. M; Łudzik, J; TEIXEIRA DE CARVALHO, Nathalie; Ciardo, S; Longo, Caterina; DI NARDO, Antonio; Pellacani, Giovanni
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1107873
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