Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna

E. Cinotti, B. Labeille, S. Debarbieux, C. Carrera, F. Lacarrubba, A. M. Witkowski, E. Moscarella, E. Arzberger, H. Kittler, P. Bahadoran, S. Gonzalez, P. Guitera, M. Agozzino, F. Farnetani, R. Hofmann-Wellenhof, M. Ardigò, P. Rubegni, L. Tognetti, J. Ludzik, I. ZalaudekG. Argenziano, C. Longo, S. Ribero, J. Malvehy, G. Pellacani, F. Cambazard, J. L. Perrot

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Abstract

Background: Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques. Objective: We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images. Methods: A total of 223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination was compared. Interinvestigator variability and confidence level in the diagnosis were also evaluated. Results: Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, vs. 61%) and less specific (81% vs. 92%) than dermoscopy for LM/LMM. In particular, RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher interinvestigator agreement and a higher confidence level in the diagnosis than dermoscopy. Conclusion: Reflectance confocal microscopy and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM.

Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Hutchinson's Melanotic Freckle
Dermoscopy
Confocal Microscopy
Melanoma
Area Under Curve

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna. / Cinotti, E.; Labeille, B.; Debarbieux, S.; Carrera, C.; Lacarrubba, F.; Witkowski, A. M.; Moscarella, E.; Arzberger, E.; Kittler, H.; Bahadoran, P.; Gonzalez, S.; Guitera, P.; Agozzino, M.; Farnetani, F.; Hofmann-Wellenhof, R.; Ardigò, M.; Rubegni, P.; Tognetti, L.; Ludzik, J.; Zalaudek, I.; Argenziano, G.; Longo, C.; Ribero, S.; Malvehy, J.; Pellacani, G.; Cambazard, F.; Perrot, J. L.

In: Journal of the European Academy of Dermatology and Venereology, 01.01.2018.

Research output: Contribution to journalArticle

Cinotti, E, Labeille, B, Debarbieux, S, Carrera, C, Lacarrubba, F, Witkowski, AM, Moscarella, E, Arzberger, E, Kittler, H, Bahadoran, P, Gonzalez, S, Guitera, P, Agozzino, M, Farnetani, F, Hofmann-Wellenhof, R, Ardigò, M, Rubegni, P, Tognetti, L, Ludzik, J, Zalaudek, I, Argenziano, G, Longo, C, Ribero, S, Malvehy, J, Pellacani, G, Cambazard, F & Perrot, JL 2018, 'Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna', Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.14791
Cinotti, E. ; Labeille, B. ; Debarbieux, S. ; Carrera, C. ; Lacarrubba, F. ; Witkowski, A. M. ; Moscarella, E. ; Arzberger, E. ; Kittler, H. ; Bahadoran, P. ; Gonzalez, S. ; Guitera, P. ; Agozzino, M. ; Farnetani, F. ; Hofmann-Wellenhof, R. ; Ardigò, M. ; Rubegni, P. ; Tognetti, L. ; Ludzik, J. ; Zalaudek, I. ; Argenziano, G. ; Longo, C. ; Ribero, S. ; Malvehy, J. ; Pellacani, G. ; Cambazard, F. ; Perrot, J. L. / Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna. In: Journal of the European Academy of Dermatology and Venereology. 2018.
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title = "Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna",
abstract = "Background: Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques. Objective: We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images. Methods: A total of 223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination was compared. Interinvestigator variability and confidence level in the diagnosis were also evaluated. Results: Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80{\%}, vs. 61{\%}) and less specific (81{\%} vs. 92{\%}) than dermoscopy for LM/LMM. In particular, RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher interinvestigator agreement and a higher confidence level in the diagnosis than dermoscopy. Conclusion: Reflectance confocal microscopy and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM.",
author = "E. Cinotti and B. Labeille and S. Debarbieux and C. Carrera and F. Lacarrubba and Witkowski, {A. M.} and E. Moscarella and E. Arzberger and H. Kittler and P. Bahadoran and S. Gonzalez and P. Guitera and M. Agozzino and F. Farnetani and R. Hofmann-Wellenhof and M. Ardig{\`o} and P. Rubegni and L. Tognetti and J. Ludzik and I. Zalaudek and G. Argenziano and C. Longo and S. Ribero and J. Malvehy and G. Pellacani and F. Cambazard and Perrot, {J. L.}",
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T1 - Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna

AU - Cinotti, E.

AU - Labeille, B.

AU - Debarbieux, S.

AU - Carrera, C.

AU - Lacarrubba, F.

AU - Witkowski, A. M.

AU - Moscarella, E.

AU - Arzberger, E.

AU - Kittler, H.

AU - Bahadoran, P.

AU - Gonzalez, S.

AU - Guitera, P.

AU - Agozzino, M.

AU - Farnetani, F.

AU - Hofmann-Wellenhof, R.

AU - Ardigò, M.

AU - Rubegni, P.

AU - Tognetti, L.

AU - Ludzik, J.

AU - Zalaudek, I.

AU - Argenziano, G.

AU - Longo, C.

AU - Ribero, S.

AU - Malvehy, J.

AU - Pellacani, G.

AU - Cambazard, F.

AU - Perrot, J. L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques. Objective: We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images. Methods: A total of 223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination was compared. Interinvestigator variability and confidence level in the diagnosis were also evaluated. Results: Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, vs. 61%) and less specific (81% vs. 92%) than dermoscopy for LM/LMM. In particular, RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher interinvestigator agreement and a higher confidence level in the diagnosis than dermoscopy. Conclusion: Reflectance confocal microscopy and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM.

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