1. Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet
- Author
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Andreas Blum, Robert O. Kenet, Takeji Nishikawa, Allan C. Halpern, Vincenzo De Giorgi, Helmut Kerl, Brian Katz, Sergio Chimenti, Rosamaria Corona, Pietro Rubegni, Paolo Carli, Domenico Piccolo, Francesco Sera, Toshiaki Saida, Robert H. Johr, Michael Landthaler, Renato Talamini, Rainer Hofmann-Wellenhof, Klaus Wolff, Roberto Perotti, Gerardo Ferrara, Ralph P. Braun, Lorenzo Cerroni, Stefania Seidenari, James M. Grichnik, Massimiliano Scalvenzi, Giuseppe Argenziano, Horacio Cabo, Masaru Tanaka, Michael Binder, Ana Perusquia, Karin Westerhoff, Margaret Oliviero, Otto Braun-Falco, Scott W. Menzies, Ignazio Stanganelli, Harald Kittler, Josep Malvehy, Igor Bartenjev, Harold S. Rabinovitz, Ketty Peris, Alfred W. Kopf, Hubert Pehamberger, Caron M. Grin, Gaetano De Rosa, Babar Rao, Susana Puig, Maria Antonietta Pizzichetta, G. Mazzocchetti, Jürgen Kreusch, H. Peter Soyer, R. Schiffner, Matthew G. Fleming, Stefania Staibano, Fezal Ozdemir, Wilhelm Stolz, Ingrid H. Wolf, Argenziano, Giuseppe, Soyer, Hp, Chimenti, S, Talamini, R, Corona, R, Sera, F, Binder, M, Cerroni, L, De Rosa, G, Ferrara, G, Hofmann Wellenhof, R, Landthater, M, Menzies, Sw, Pehamberger, H, Piccolo, D, Rabinovitz, H, Schiffner, R, Staibano, S, Stolz, W, Bartenjev, I, Blum, A, Braun, R, Cabo, H, Carli, P, De Giorgi, V, Fleming, Mg, Grichnik, Jm, Grin, Cm, Halpern, Ac, Johr, R, Katz, B, Kenet, Ro, Kittler, H, Kreusch, J, Malvehy, J, Mazzocchetti, G, Oliviero, M, Ozdemir, F, Peris, K, Perotti, R, Perusquia, A, Pizzichetta, Ma, Puig, S, Rao, B, Rubegni, P, Saida, T, Scalvenzi, M, Seidenari, S, Stanganelli, I, Tanaka, M, Westerhoff, K, Wolf, Ih, Braun Falco, O, Kerl, H, Nishikawa, T, Wolff, K., Argenziano, G, DE ROSA, Gaetano, Landthaler, M, Staibano, Stefania, Scalvenzi, Massimiliano, Wolff, K, and Kopf, Aw
- Subjects
medicine.medical_specialty ,Skin Neoplasms ,diagnosis/pathology, Diagnosi ,Diagnostic methods ,Log odds ,Basal Cell ,Pattern analysis ,Dermoscopy ,Skin Pigmentation ,Differential, Humans, Internet, Melanoma ,Dermatology ,consensus meeting ,Sensitivity and Specificity ,Skin Diseases ,Likelihood ratios in diagnostic testing ,Diagnosis, Differential ,Reference Values ,Terminology as Topic ,Photography ,medicine ,Humans ,Melanoma ,Algorithms, Carcinoma ,dermoscopy ,pigmented skin lesions ,diagnosis/pathology, Skin Neoplasm ,classification/diagnosis/pathology, Skin Pigmentation, Terminology as Topic ,Internet ,Microscopy ,Dermatoscopy ,methods/standards, Photography, Practice Guidelines as Topic, Reference Values, Sensitivity and Specificity, Skin Disease ,medicine.diagnostic_test ,business.industry ,Diagnostic algorithms ,Abcd rule ,Carcinoma, Basal Cell ,Practice Guidelines as Topic ,classification/diagnosis/pathology, Microscopy ,Pigmented skin ,business ,Algorithms - Abstract
Background: There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions. Objective: The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms. Methods: Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experienced dermoscopists using a 2-step diagnostic procedure. The first-step algorithm distinguished melanocytic versus nonmelanocytic lesions. The second step in the diagnostic procedure used 4 algorithms (pattern analysis, ABCD rule, Menzies method, and 7-point checklist) to distinguish melanoma versus benign melanocytic lesions. κ Values, log odds ratios, sensitivity, specificity, and positive likelihood ratios were estimated for all diagnostic algorithms and dermoscopic features. Results: Interobserver agreement was fair to good for all diagnostic methods, but it was poor for the majority of dermoscopic criteria. Intraobserver agreement was good to excellent for all algorithms and features considered. Pattern analysis allowed the best diagnostic performance (positive likelihood ratio: 5.1), whereas alternative algorithms revealed comparable sensitivity but less specificity. Interobserver agreement on management decisions made by dermoscopy was fairly good (mean κ value: 0.53). Conclusion: The virtual Consensus Net Meeting on Dermoscopy represents a valid tool for better standardization of the dermoscopic terminology and, moreover, opens up a new territory for diagnosing and managing pigmented skin lesions. (J Am Acad Dermatol 2003;48:679-93.) J Am Acad Dermatol 2003;48:679-93.
- Published
- 2003