Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet - 29/08/11

Doi : 10.1067/mjd.2003.281

Giuseppe Argenziano, MD^a, H.Peter Soyer, MD^b, Sergio Chimenti, MD^c, Renato Talamini, ScD^d, Rosamaria Corona, MD, DSc^e, Francesco Sera, DStat^e, Michael Binder, MD^f, Lorenzo Cerroni, MD^b, Gaetano De Rosa, MD^g, Gerardo Ferrara, MD^h, Rainer Hofmann-Wellenhof, MD^b, Michael Landthaler, MDⁱ, Scott W. Menzies, MBBS, PhD^j, Hubert Pehamberger, MD^f, Domenico Piccolo, MD^k, Harold S. Rabinovitz, MD^l, Roman Schiffner, MDⁱ, Stefania Staibano, MD^g, Wilhelm Stolz, MDⁱ, Igor Bartenjev, MD^m, Andreas Blum, MDⁿ, Ralph Braun, MD^o, Horacio Cabo, MD^p, Paolo Carli, MD^q, Vincenzo De Giorgi, MD^q, Matthew G. Fleming, MD^r, James M. Grichnik, MD, PhD^s, Caron M. Grin, MD^t, Allan C. Halpern, MD^u, Robert Johr, MD^v, Brian Katz, MD^e, Robert O. Kenet, MD, PhD^x, Harald Kittler, MD^f, Jürgen Kreusch, MD^y, Josep Malvehy, MD^z, Giampiero Mazzocchetti, MD^a, Margaret Oliviero, ARNP^l, Fezal Özdemir, MD^b, Ketty Peris, MD^k, Roberto Perotti, MD^c, Ana Perusquia, MD^d, Maria Antonietta Pizzichetta, MD^d, Susana Puig, MD^z, Babar Rao, MD^e, Pietro Rubegni, MD^c, Toshiaki Saida, MD^f, Massimiliano Scalvenzi, MD^g, Stefania Seidenari, MD^h, Ignazio Stanganelli, MDⁱ, Masaru Tanaka, MD^j, Karin Westerhoff, MD^k, Ingrid H. Wolf, MD^b, Otto Braun-Falco, MD^l, Helmut Kerl, MD^b, Takeji Nishikawa, MD^j, Klaus Wolff, MD^f, Alfred W. Kopf, MD^m
Naples, Rome, Aviano, Benevento, L'Aquila, Florence, Atessa, Siena, Modena, Milan, and Ravenna, Italy; Graz and Vienna, Austria; Regensburg, Tübingen, Lübeck, and Munich, Germany; Camperdown, Australia; Plantation and Miami, Florida; Ljubljana, Slovenia; Geneva, Switzerland; Buenos Aires, Argentina; Milwaukee, Wisconsin; Durham, North Carolina; Farmington, Connecticut; Barcelona, Spain; Izmir, Turkey; Mexico City, Mexico; New Brunswick, New Jersey; Matsumoto and Tokyo, Japan; Skövde, Sweden; and New York, New York
From the Departments of Dermatology at Second University of Naples,^a University of Graz,^b University Tor Vergata of Rome,^c University of Vienna,^f University of Regensburg,ⁱ University of L'Aquila,^k University Clinical Center Ljubljana,^m University of Tübingen,ⁿ University Hospital Geneva,^o Hospital de Clínicas, University of Buenos Aires,^p University of Florence,^q Medical College of Wisconsin,^r University of Connecticut School of Medicine,^t University at Luebeck,^y University of Barcelona,^z Medical Faculty, Ege University,^b University of Siena,^c Hospital Español,^d Shinshu University School of Medicine,^f University Federico II,^g University of Modena,^h Keio University School of Medicine,^j Skövde Hospital,^k University of Munich,^l and New York University School of Medicine, New York University Medical Center^m; National Cancer Institute^d; Istituto Dermopatico dell'Immacolata^e; Institute of Pathology, University Federico II^g; Pathologic Anatomy Service, Gaetano Rummo General Hospital^h; Sydney Melanoma Unit, Sydney Cancer Centre, Melanoma and Skin Cancer Research Institute, University of Sydney at Royal Prince Alfred Hospital^j; Skin and Cancer Associates, Department of Dermatology, University of Miami School of Medicine^l; Department of Medicine, Division of Dermatology, Duke University Medical Center^s; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center^u; Pigmented Lesion Clinic, Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine^v; Department of Medicine, New York-Presbyterian Hospital and Weill Medical College of Cornell University^x; Dermatology Service, Vittorio Emanuele Hospital^a; Division of Dermatology, Robert Wood Johnson Medical School-University of Medicine and Dentistry of New Jersey^e; and Cutaneous Oncology Unit, Niguarda Ca' Granda Hospital, and Center for Cancer Prevention, Ravenna Hospital.ⁱ

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.

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Plan

Materials and methods

Selection of participants and dermoscopic criteria

Selection of PSL for evaluation

Standards used for digital documentation of dermoscopic images

Methodology of evaluation of cases via the Internet

Statistics

Results

Discussion

	All technical issues related to this Internet study supported by Edra Medical Publishing and New Media, Milan, Italy.
	Conflict of interest: None identified.
	Reprint requests: H. Peter Soyer, MD, Department of Dermatology, University of Graz, Auenbruggerplatz 8 - A8036 Graz, Austria. E-mail: peter.soyer@uni-graz.at.
	0190-9622/2003/$30.00 + 0

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Vol 48 - N° 5

P. 679-693 - mai 2003 Retour au numéro

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Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet - 29/08/11

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