A risk‐scoring model for the differential diagnosis of lentigo maligna and other atypical pigmented facial lesions of the face: The facial iDScore

Author:

Tognetti Linda1ORCID,Cartocci Alessandra12ORCID,Żychowska Magdalena3ORCID,Savarese Imma4,Cinotti Elisa1,Pizzichetta Maria Antonietta56ORCID,Moscarella Elvira7ORCID,Longo Caterina89,Farnetani Francesca9ORCID,Guida Stefania1011ORCID,Paoli John1213ORCID,Lallas Aimilios14ORCID,Tiodorovic Danica15,Stanganelli Ignazio1617,Magi Serena16,Dika Emi1819ORCID,Zalaudek Iris5,Suppa Mariano202122ORCID,Argenziano Giuseppe7ORCID,Pellacani Giovanni23ORCID,Perrot Jean Luc24,Miracapillo Chiara1,Rubegni Giovanni25,Cevenini Gabriele26,Rubegni Pietro1

Affiliation:

1. Dermatology Unit, Department of Medical, Surgical and Neurosciences University of Siena Siena Italy

2. Department of Medical Biotechnologies University of Siena Siena Italy

3. Department of Dermatology, Institute of Medical Sciences Medical College of Rzeszow University Rzeszów Poland

4. Soc Dermatologia Pistoia‐Prato, USL Toscana Centro Pistoia Italy

5. Dermatology Clinic Ospedale di Trieste Trieste Italy

6. Department of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO), IRCCS Aviano Italy

7. Dermatology Unit University of Campania Luigi Vanvitelli Naples Italy

8. Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia Reggio Emilia Italy

9. Department of Dermatology University of Modena and Reggio Emilia Modena Italy

10. Vita‐Salute San Raffaele University Milan Italy

11. Dermatology Clinic IRCCS San Raffaele Scientific Institute Milan Italy

12. Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden

13. Department of Dermatology and Venereology Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden

14. First Department of Dermatology Aristotle University Thessaloniki Greece

15. Dermatology Clinic, Medical Faculty University of Nis Niš Serbia

16. Skin Cancer Unit Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST Meldola Italy

17. Department of Dermatology University of Parma Parma Italy

18. Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna Bologna Italy

19. Dermatology IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy

20. Department of Dermatology, Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

21. Groupe d'Imagerie Cutanée Non‐Invasive, Société Française de Dermatologie Paris France

22. Department of Dermatology Institut Jules Bordet Brussels Belgium

23. Department of Dermatology, Policlinico Umberto I University of Rome La Sapienza Rome Italy

24. Dermatology Unit University Hospital of St‐Etienne Saint Etienne France

25. Department of Ophthalmology University of Catania Catania Italy

26. Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies University of Siena Siena Italy

Abstract

AbstractBackgroundDue to progressive ageing of the population, the incidence of facial lentigo maligna (LM) of the face is increasing. Many benign simulators of LM and LMM, known as atypical pigmented facial lesions (aPFLs—pigmented actinic keratosis, solar lentigo, seborrheic keratosis, seborrheic‐lichenoid keratosis, atypical nevus) may be found on photodamaged skin. This generates many diagnostic issues and increases the number of biopsies, with a subsequent impact on aesthetic outcome and health insurance costs.ObjectivesOur aim was to develop a risk‐scoring classifier‐based algorithm to estimate the probability of an aPFL being malignant. A second aim was to compare its diagnostic accuracy with that of dermoscopists so as to define the advantages of using the model in patient management.Materials and MethodsA total of 154 dermatologists analysed 1111 aPFLs and their management in a teledermatology setting: They performed pattern analysis, gave an intuitive clinical diagnosis and proposed lesion management options (follow‐up/reflectance confocal microscopy/biopsy). Each case was composed of a dermoscopic and/or clinical picture plus metadata (histology, age, sex, location, diameter). The risk‐scoring classifier was developed and tested on this dataset and then validated on 86 additional aPFLs.ResultsThe facial Integrated Dermoscopic Score (iDScore) model consisted of seven dermoscopic variables and three objective parameters (diameter ≥ 8 mm, age ≥ 70 years, male sex); the score ranged from 0 to 16. In the testing set, the facial iDScore‐aided diagnosis was more accurate (AUC = 0.79 [IC 95% 0.757–0.843]) than the intuitive diagnosis proposed by dermatologists (average of 43.5%). In the management study, the score model reduced the number of benign lesions sent for biopsies by 41.5% and increased the number of LM/LMM cases sent for reflectance confocal microscopy or biopsy instead of follow‐up by 66%.ConclusionsThe facial iDScore can be proposed as a feasible tool for managing patients with aPFLs.

Publisher

Wiley

Subject

Infectious Diseases,Dermatology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3