Abstract
Limited studies have reported the in vivo reflectance confocal microscopy (RCM) features of lentigo maligna (LM). A total of 64 RCM features were scored retrospectively and blinded to diagnosis in a consecutive series of RCM sampled, clinically equivocal, macules of the face (n81 LM, n203 benign macules (BMs)). In addition to describing RCM diagnostic features for LM (univariate), an algorithm was developed (LM score) to distinguish LM from BM. This comprised two major features each scoring 2 points (nonedged papillae and round large pagetoid cells 20 m), and four minor features; three scored 1 point each (three or more atypical cells at the dermoepidermal junction in five 0.5 × 0.5 mm 2 fields, follicular localization of atypical cells, and nucleated cells within the dermal papillae), and one (negative) feature scored 1 point (a broadened honeycomb pattern). A LM score of 2 resulted in a sensitivity of 85% and specificity of 76% for the diagnosis of LM (odds ratio (OR) for LM 18.6; 95% confidence interval: 9.3-37.1). The algorithm was equally effective in the diagnosis of amelanotic lesions and showed good interobserver reproducibility (87%). In a test set of 29 LMs and 44 BMs, the OR for LM was 60.7 (confidence interval: 11.9-309) (93% sensitivity, 82% specificity).
| Original language | English |
|---|---|
| Pages (from-to) | 2080-2091 |
| Number of pages | 12 |
| Journal | Journal of Investigative Dermatology |
| Volume | 130 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2010 |
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ASJC Scopus subject areas
- Dermatology
- Biochemistry
- Cell Biology
- Molecular Biology
Cite this
The impact of in vivo reflectance confocal microscopy on the diagnostic accuracy of lentigo maligna and equivocal pigmented and nonpigmented macules of the face. / Guitera, Pascale; Pellacani, Giovanni; Crotty, Kerry A.; Scolyer, Richard A.; Li, Ling Xi L; Bassoli, Sara; Vinceti, Marco; Rabinovitz, Harold; Longo, Caterina; Menzies, Scott W.
In: Journal of Investigative Dermatology, Vol. 130, No. 8, 08.2010, p. 2080-2091.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The impact of in vivo reflectance confocal microscopy on the diagnostic accuracy of lentigo maligna and equivocal pigmented and nonpigmented macules of the face
AU - Guitera, Pascale
AU - Pellacani, Giovanni
AU - Crotty, Kerry A.
AU - Scolyer, Richard A.
AU - Li, Ling Xi L
AU - Bassoli, Sara
AU - Vinceti, Marco
AU - Rabinovitz, Harold
AU - Longo, Caterina
AU - Menzies, Scott W.
PY - 2010/8
Y1 - 2010/8
N2 - Limited studies have reported the in vivo reflectance confocal microscopy (RCM) features of lentigo maligna (LM). A total of 64 RCM features were scored retrospectively and blinded to diagnosis in a consecutive series of RCM sampled, clinically equivocal, macules of the face (n81 LM, n203 benign macules (BMs)). In addition to describing RCM diagnostic features for LM (univariate), an algorithm was developed (LM score) to distinguish LM from BM. This comprised two major features each scoring 2 points (nonedged papillae and round large pagetoid cells 20 m), and four minor features; three scored 1 point each (three or more atypical cells at the dermoepidermal junction in five 0.5 × 0.5 mm 2 fields, follicular localization of atypical cells, and nucleated cells within the dermal papillae), and one (negative) feature scored 1 point (a broadened honeycomb pattern). A LM score of 2 resulted in a sensitivity of 85% and specificity of 76% for the diagnosis of LM (odds ratio (OR) for LM 18.6; 95% confidence interval: 9.3-37.1). The algorithm was equally effective in the diagnosis of amelanotic lesions and showed good interobserver reproducibility (87%). In a test set of 29 LMs and 44 BMs, the OR for LM was 60.7 (confidence interval: 11.9-309) (93% sensitivity, 82% specificity).
AB - Limited studies have reported the in vivo reflectance confocal microscopy (RCM) features of lentigo maligna (LM). A total of 64 RCM features were scored retrospectively and blinded to diagnosis in a consecutive series of RCM sampled, clinically equivocal, macules of the face (n81 LM, n203 benign macules (BMs)). In addition to describing RCM diagnostic features for LM (univariate), an algorithm was developed (LM score) to distinguish LM from BM. This comprised two major features each scoring 2 points (nonedged papillae and round large pagetoid cells 20 m), and four minor features; three scored 1 point each (three or more atypical cells at the dermoepidermal junction in five 0.5 × 0.5 mm 2 fields, follicular localization of atypical cells, and nucleated cells within the dermal papillae), and one (negative) feature scored 1 point (a broadened honeycomb pattern). A LM score of 2 resulted in a sensitivity of 85% and specificity of 76% for the diagnosis of LM (odds ratio (OR) for LM 18.6; 95% confidence interval: 9.3-37.1). The algorithm was equally effective in the diagnosis of amelanotic lesions and showed good interobserver reproducibility (87%). In a test set of 29 LMs and 44 BMs, the OR for LM was 60.7 (confidence interval: 11.9-309) (93% sensitivity, 82% specificity).
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U2 - 10.1038/jid.2010.84
DO - 10.1038/jid.2010.84
M3 - Article
VL - 130
SP - 2080
EP - 2091
JO - Journal of Investigative Dermatology
JF - Journal of Investigative Dermatology
SN - 0022-202X
IS - 8
ER -