Validation of a Dermatoscopy-Based Algorithm for the Diagnosis of Acral Melanoma.

IF 3 3区医学 Q2 DERMATOLOGY

Dermatology Pub Date : 2024-01-01 Epub Date: 2024-10-05 DOI:10.1159/000541591

Christoph Müller, Harald Kittler, Philipp Tschandl, Christoph Rinner, Marie-Luise Grausenburger, Athanassios Kyrgidis, Hiroshi Koga, Elvira Moscarella, Zoe Apalla, Alessandro Di Stefani, Ken Kobayashi, Elisabeth Lazaridou, Caterina Longo, Alice Phan, Toshiaki Saida, Elena Sotiriou, Masaru Tanaka, Luc Thomas, Iris Zalaudek, Giuseppe Argenziano, Aimilios Lallas

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引用次数: 0

Abstract

Introduction: Diagnosis of acral melanocytic lesions can be challenging. The BRAAFF checklist was introduced as a tool to help differentiate between acral nevi and melanoma but has not been validated.

Methods: We asked raters with varying expertise in dermatoscopy to diagnose dermatoscopic images of 533 acral nevi and 144 melanomas via an online platform with and without use of the BRAAFF checklist. From the ratings, we calculated sensitivity, specificity, and interrater agreement. Additionally, a new simplified version of the checklist was also tested.

Results: We collected 6,880 ratings from 175 readers. The BRAAFF checklist achieved a sensitivity of 92.5% and a specificity of 65.0%, which was similar to diagnosis from pattern recognition (sensitivity 90.0%, specificity: 72.1%). Interrater agreement for the BRAAFF criteria ranged from fair to moderate, with lowest agreement for parallel ridge and fibrillar pattern (alpha = 0.31) and highest for asymmetry of colors and structures (alpha = 0.46). Agreement and diagnostic accuracy were higher for more experienced readers. A simplified version with only two criteria achieved similar sensitivity (95.0%) and lower specificity (60.0%) as the original BRAAFF checklist.

Conclusion: The BRAAFF checklist is a useful tool for the diagnosis of melanocytic acral lesions with acceptable sensitivity and reasonable specificity but is not superior to pattern recognition. A simplified version of the checklist could be easier to use with equal sensitivity while exhibiting a modest reduction in specificity.

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验证基于皮肤镜的尖锐湿疣黑色素瘤诊断算法。

简介尖锐湿疣黑色素细胞病变的诊断具有挑战性。BRAAFF核对表作为一种工具被引入以帮助区分尖锐痣和黑色素瘤，但尚未得到验证：方法：我们请具有不同皮肤镜专业知识的评分员通过在线平台，在使用或不使用 BRAAFF 核对表的情况下，对 533 个尖锐痣和 144 个黑色素瘤的皮肤镜图像进行诊断。根据评分结果，我们计算出了灵敏度、特异性和评分者之间的一致性。此外，我们还测试了新的简化版核对表：结果：我们收集了 175 位读者的 6880 个评分。BRAAFF 检查表的灵敏度为 92.5%，特异性为 65.0%，与模式识别诊断（灵敏度 90.0%，特异性 72.1%）相似。BRAAFF标准的互译一致性从一般到中等不等，其中平行脊和纤维模式的一致性最低（α=0.31），颜色和结构不对称的一致性最高（α=0.46）。经验丰富的读者的一致性和诊断准确性更高。只有两个标准的简化版与原始 BRAAFF 核对表的灵敏度（95.0%）相似，特异性（60.0%）较低。结论：BRAAFF 检查表是诊断黑素细胞性尖锐湿疣病变的有用工具，具有可接受的灵敏度和合理的特异性，但并不优于模式识别。简化版核对表更易于使用，敏感性相同，但特异性略有降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology 医学-皮肤病学

CiteScore

6.40

自引率

2.90%

发文量

审稿时长

1 months

期刊介绍： Published since 1893, ''Dermatology'' provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform readers of the implications of recent research, editorials and reviews prepared by invited, internationally recognized scientists are regularly featured. In addition to original papers, the journal publishes rapid communications, short communications, and letters to ''Dermatology''. ''Dermatology'' answers the complete information needs of practitioners concerned with progress in research related to skin, clinical dermatology and therapy. The journal enjoys a high scientific reputation with a continually increasing impact factor and an equally high circulation.