Diagnostic accuracy of magnified dermoscopy and reflectance confocal microscopy in assessing melanocytic lesions
Keywords:
Magnified dermoscopy, Reflectance confocal microscopy, Diagnostic accuracy, Melanoma, Melanocytic lesionsAbstract
Introduction: Magnified dermoscopy (MD), or optical super-high magnification dermoscopy is an emerging technique in dermatology.
Objectives: The study aims to evaluate the distribution of conventional dermoscopy, MD, and reflectance confocal microscopy (RCM) features in dermoscopically equivocal pigmented lesions and to estimate their diagnostic accuracy.
Methods :A retrospective analysis of conventional dermoscopic (´20), MD (´400) and RCM pictures of dermoscopically equivocal pigmented lesions, diagnosed as either nevi or melanoma, was performed. Distribution of features, sensitivity, and specificity for dermoscopy, MD, RCM and a combination of these last 2 with conventional dermoscopy were estimated.
Results: A total of 74 nevi and 20 melanomas were included in the analysis. A positive correlation was observed between a 7-point checklist in conventional dermoscopy and the diagnosis of melanoma. With MD, a significant correlation between dots, non-edged papillae, and melanoma was observed, but the technique did not significantly impact diagnostic accuracy as compared to traditional dermoscopy. On the other hand, RCM, alone or in combimation with traditional dermoscopy, iincreased diagnostic accuracy, in particular, specificity for melanoma diagnosis.
Conclusions: RCM has a defined role in increasing diagnostic accuracy of doubtful dermoscopic lesions while the role of MD in clinical practice has yet to be defined and methodologic standardization as well as a revision of terminology is encouraged to improve the recognition of features.
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Copyright (c) 2025 Stefania Guida, Silvana Ciardo, Shaniko Kaleci, Francesca Farnetani, Marco Spadafora, Giulia Radi, Renato Rossi, Elisa Molinelli, Sabrina Longhitano, Claudio Conforti, Carmen Cantisani, Camilla Chello, Oriana Simonetti, Anna Maria Offidani, Pietro Rubegni, Franco Rongioletti, Caterina Longo, Elisa Cinotti, Giovanni Pellacani
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