Diagnosis and categorization of acral melanocytic lesions using teledermoscopy

Abstract

We performed a multicentre study to test the validity of teledermoscopy for diagnosing acral melanoma and to evaluate inter-observer agreement on the classification of acral melanocytic lesions. Dermoscopic images of 77 acral melanocytic lesions (71 common melanocytic naevi and 6 melanomas) were sent by email to 11 dermatologists with different degrees of experience in dermoscopy. The observers analysed the images on a computer monitor to diagnose acral melanoma or atypical lesions and to categorize all lesions. All 11 observers, regardless of their degree of experience, obtained high values for sensitivity (mean 0.91, SD 0.09) and specificity (mean 0.95, SD 0.04) with regard to the diagnosis of melanoma. The inter-observer agreement was good to excellent (kappa 0.49-0.88) for the categorization of acral melanocytic lesions. All six melanomas were correctly classified as 'atypical pattern' and all observers recommended surgical excision. Teledermoscopy represents a useful tool for the diagnosis of acral melanoma and for the categorization of patterns that suggest benign or potentially malignant acral melanocytic lesions.

Dermoscopy of Acral Melanoma: A Multicenter Study on Behalf of the International Dermoscopy Society

“…With 66 acral melanomas this is the largest series on dermoscopy of acral melanoma in a predominantly Caucasian population to date [13,14,15,16]. Eight lesions (3 melanomas) were from Asian patients.…”

Teledermatology for diagnosis and management of skin conditions: A systematic review

“…All studies used a repeated measures study design with the exception of one randomized controlled trial. 11 Based on location, most of the studies were conducted in the United States (n = 14), [3][4][5][6]22,24,25,33,35,37,[41][42][43]45 followed by the United Kingdom (n = 9), 11,12,15,18,29,30,32,38,44 Italy (n = 6), 7,8,20,21,36,39 Spain (n = 4), 9,10,13,17 Australia/New Zealand (n = 3), 14,31,40 Turkey (n = 2), 16,19 and one study each from Germany, 23 Netherlands, 24 Pakistan, 27 Brazil, 28 and Switzerland. 34 Patient and skin condition characteristics.…”

“…Fourteen studies included subjects younger than 18 years. 3,6,8,13,14,16,17,20,21,29,30,35,36,39 In 22 studies reporting gender, most of the subjects were male (57% overall, range 29%-98%). Only 6 studies, all conducted in the United States, reported racial or ethnic characteristics.…”

Accuracy of teledermatology for nonpigmented neoplasms

“…In a smaller study by the same investigators of 13 lesions (pigmentation status not reported), aggregated diagnostic accuracy was 80% and 92% for two different clinic dermatologists and 85% for two different teledermatologists using macro images only. 11 Several studies have specifically evaluated pigmented lesions with teledermatology and/or teledermatoscopy [23][24][25][26][27][28][29] but only one, to our knowledge, specifically reported results for nonpigmented lesions. Fabbrocini and colleagues 30 evaluated 44 ''difficult pink lesions'' and reported a ''correct diagnosis'' rate of 66% for clinicians versus 52% for teledermatologists using teledermatoscopy with immersion oil.…”