Non-invasive diagnosis of pink basal cell carcinoma: How much can we rely on dermoscopy and reflectance confocal microscopy?

A. M. Witkowski, J. Łudzik, N. Decarvalho, S. Ciardo, C. Longo, A. Dinardo, G. Pellacani

Research output: Contribution to journalArticle

Abstract

Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.

Original languageEnglish
Pages (from-to)230-7
Number of pages8
JournalSkin Research and Technology
Volume22
Issue number2
DOIs
Publication statusPublished - May 1 2016

Fingerprint

Dermoscopy
Basal Cell Carcinoma
Confocal Microscopy
Melanoma
Skin
Diagnostic Errors
Sensitivity and Specificity
Differential Diagnosis
Squamous Cell Carcinoma
Neoplasms
Safety

Keywords

  • Basal cell carcinoma
  • Dermoscopy
  • Melanoma
  • Reflectance confocal microscopy

ASJC Scopus subject areas

  • Dermatology

Cite this

Non-invasive diagnosis of pink basal cell carcinoma : How much can we rely on dermoscopy and reflectance confocal microscopy? / Witkowski, A. M.; Łudzik, J.; Decarvalho, N.; Ciardo, S.; Longo, C.; Dinardo, A.; Pellacani, G.

In: Skin Research and Technology, Vol. 22, No. 2, 01.05.2016, p. 230-7.

Research output: Contribution to journalArticle

Witkowski, A. M. ; Łudzik, J. ; Decarvalho, N. ; Ciardo, S. ; Longo, C. ; Dinardo, A. ; Pellacani, G. / Non-invasive diagnosis of pink basal cell carcinoma : How much can we rely on dermoscopy and reflectance confocal microscopy?. In: Skin Research and Technology. 2016 ; Vol. 22, No. 2. pp. 230-7.
@article{b7a653d50fe8476b8c6f72ccf9fb8110,
title = "Non-invasive diagnosis of pink basal cell carcinoma: How much can we rely on dermoscopy and reflectance confocal microscopy?",
abstract = "Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1{\%} and specificity of 92.4{\%}, resulting in a positive predictive value (PPV) of 89.8{\%}, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1{\%} and specificity of 93.8{\%}, resulting in a PPV of 91.5{\%}, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2{\%} and specificity of 96.6{\%}, resulting in a PPV of 94.6{\%}. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.",
keywords = "Basal cell carcinoma, Dermoscopy, Melanoma, Reflectance confocal microscopy",
author = "Witkowski, {A. M.} and J. Łudzik and N. Decarvalho and S. Ciardo and C. Longo and A. Dinardo and G. Pellacani",
year = "2016",
month = "5",
day = "1",
doi = "10.1111/srt.12254",
language = "English",
volume = "22",
pages = "230--7",
journal = "Skin Research and Technology",
issn = "0909-752X",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Non-invasive diagnosis of pink basal cell carcinoma

T2 - How much can we rely on dermoscopy and reflectance confocal microscopy?

AU - Witkowski, A. M.

AU - Łudzik, J.

AU - Decarvalho, N.

AU - Ciardo, S.

AU - Longo, C.

AU - Dinardo, A.

AU - Pellacani, G.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.

AB - Background: Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. Methods: Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. Results: Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. Conclusion: The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.

KW - Basal cell carcinoma

KW - Dermoscopy

KW - Melanoma

KW - Reflectance confocal microscopy

UR - http://www.scopus.com/inward/record.url?scp=84950255861&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84950255861&partnerID=8YFLogxK

U2 - 10.1111/srt.12254

DO - 10.1111/srt.12254

M3 - Article

AN - SCOPUS:84950255861

VL - 22

SP - 230

EP - 237

JO - Skin Research and Technology

JF - Skin Research and Technology

SN - 0909-752X

IS - 2

ER -