Accuracy of dermatoscopy for the diagnosis of nonpigmented cancers of the skin.
BACKGROUND
Nonpigmented skin cancer is common, and diagnosis with the unaided eye is error prone.


OBJECTIVE
To investigate whether dermatoscopy improves the diagnostic accuracy for nonpigmented (amelanotic) cutaneous neoplasms.


METHODS
We collected a sample of 2072 benign and malignant neoplastic lesions and inflammatory conditions and presented close-up images taken with and without dermatoscopy to 95 examiners with different levels of experience.


RESULTS
The area under the curve was significantly higher with than without dermatoscopy (0.68 vs 0.64, P < .001). Among 51 possible diagnoses, the correct diagnosis was selected in 33.1% of cases with and 26.4% of cases without dermatoscopy (P < .001). For experts, the frequencies of correct specific diagnoses of a malignant lesion improved from 40.2% without to 51.3% with dermatoscopy. For all malignant neoplasms combined, the frequencies of appropriate management strategies increased from 78.1% without to 82.5% with dermatoscopy.


LIMITATIONS
The study deviated from a real-life clinical setting and was potentially affected by verification and selection bias.


CONCLUSIONS
Dermatoscopy improves the diagnosis and management of nonpigmented skin cancer and should be used as an adjunct to examination with the unaided eye.
['Sinz|Christoph|C|', 'Tschandl|Philipp|P|', 'Rosendahl|Cliff|C|', 'Akay|Bengu Nisa|BN|', 'Argenziano|Giuseppe|G|', 'Blum|Andreas|A|', 'Braun|Ralph P|RP|', 'Cabo|Horacio|H|', 'Gourhant|Jean-Yves|JY|', 'Kreusch|Juergen|J|', 'Lallas|Aimilios|A|', 'Lapins|Jan|J|', 'Marghoob|Ashfaq A|AA|', 'Menzies|Scott W|SW|', 'Paoli|John|J|', 'Rabinovitz|Harold S|HS|', 'Rinner|Christoph|C|', 'Scope|Alon|A|', 'Soyer|H Peter|HP|', 'Thomas|Luc|L|', 'Zalaudek|Iris|I|', 'Kittler|Harald|H|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002648:Child D046169:Dermoscopy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D015203:Reproducibility of Results D012878:Skin Neoplasms D055815:Young Adult
dermatoscopy diagnosis nonpigmented skin cancer dermoscopy keratinocytic skin cancer melanoma