Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar-Apr;88(2):199-203.
doi: 10.1590/S0365-05962013000200002.

Correlation between dermoscopic and histopathological diagnoses of atypical nevi in a dermatology outpatient clinic of the Medical School of São José do Rio Preto, SP, Brazil

João Roberto Antonio  1 , Rosa Maria Cordeiro Soubhia, Solange Corrêa Garcia Pires D'Avila, Adriana Cristina Caldas, Lívia Arroyo Trídico, Fernanda Tomé Alves
Affiliations

Correlation between dermoscopic and histopathological diagnoses of atypical nevi in a dermatology outpatient clinic of the Medical School of São José do Rio Preto, SP, Brazil

João Roberto Antonio et al. An Bras Dermatol. 2013 Mar-Apr.

Abstract
in English, Portuguese

Background: The incidence of cutaneous melanoma is increasing worldwide. Since it is an aggressive neoplasm, it is difficult to treat in advanced stages; early diagnosis is important to heal the patient. Melanocytic nevi are benign pigmented skin lesions while atypical nevi are associated with the risk of developing melanoma because they have a different histological pattern than common nevi. Thus, the clinical diagnosis of pigmented lesions is of great importance to differentiate benign, atypical and malignant lesions. Dermoscopy appeared as an auxiliary test in vivo, playing an important role in the diagnosis of pigmented lesions, because it allows the visualization of structures located below the stratum corneum. It shows a new morphological dimension of these lesions to the dermatologist and allows greater diagnostic accuracy. However, histopathology is considered the gold standard for the diagnosis.

Objectives: To establish the sensitivity and specificity of dermoscopy in the diagnosis of pigmented lesions suspected of malignancy (atypical nevi), comparing both the dermatoscopic with the histopathological diagnosis, at the Dermatology Service of the outpatient clinic of Hospital de Base, São José do Rio Preto, SP.

Methods: Analysis of melanocytic nevi by dermoscopy and subsequent biopsy on suspicion of atypia or if the patient so desires, for subsequent histopathological diagnosis.

Results: Sensitivity: 93%. Specificity: 42%.

Conclusions: Dermoscopy is a highly sensitive method for the diagnosis of atypical melanocytic nevi. Despite the low specificity with many false positive diagnoses, the method is effective for scanning lesions with suspected features of malignancy.

FUNDAMENTOS: A incidência do melanoma cutâneo tem aumentado mundialmente e, por ser uma neoplasia agressiva de difícil tratamento em estágios avançados, o diagnóstico precoce é fundamental para cura do paciente. Os nevos melanocíticos são lesões pigmentadas benignas da pele, enquanto os nevos atípicos, por possuírem padrão histológico diferente dos nevos comuns, estão associados ao risco de desenvolvimento de melanoma cutâneo. Dessa forma, o diagnóstico clínico das lesões pigmentadas é de grande importância para diferenciar lesões benignas, atípicas e malignas. A dermatoscopia surgiu como um exame auxiliar in vivo, com papel fundamental no diagnóstico de lesões pigmentadas. Como permite a visualização das estruturas localizadas abaixo do estrato córneo, traz uma nova dimensão morfológica dessas lesões para o dermatologista, permitindo maior precisão diagnóstica, porém, o diagnóstico padrão ouro é a histopatologia.

OBJETIVOS: Estabelecer a sensibilidade e especificidade da dermatoscopia no Serviço de Dermatologia do Ambulatório do Hospital de Base da cidade de São José do Rio Preto, SP, no diagnóstico de lesões pigmentadas com suspeita de malignidade (nevos atípicos), comparando o diagnóstico dermatoscópico ao histopatológico.

MÉTODOS: Análise de nevos melanocíticos por dermatoscopia e conseqüente biópsia em caso de suspeita de atipia, ou caso o paciente desejar, para realizar posterior diagnóstico histopatológico.

Resultados: Sensibilidade: 93%. Especificidade: 42%.

CONCLUSÕES: A dermatoscopia é um método altamente sensível para o diagnóstico de nevos melanocíticos atípicos. Apesar da baixa especificidade, apresentando grande quantidade de diagnósticos falsos positivos, o método é eficaz no objetivo de rastrear lesões com características suspeitas de malignidade.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None.

Figures

FIGURE 1
FIGURE 1
One of the 53 false positive lesions dermoscopically diagnosed as atypical, but that received the histopathologic diagnosis of composed melanocytic nevi without atypia
GRAPH 1
GRAPH 1
Sensitivity of dermoscopy
GRAPH 2
GRAPH 2
Specificity of dermoscopy
See this image and copyright information in PMC

References

    1. Instituto Nacional de Câncer (Brasil) Prevenção e controle do câncer: normas e recomendações do INCA. Rev Bras Cancerol. 2002;48:317–332.
    1. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Zanetti R, Masini C, et al. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005;41:2040–2059. - PubMed
    1. Harmful effects of ultraviolet radiation. Council on Scientific Affairs. JAMA. 1989;262:380–384. - PubMed
    1. Bonfá R, Bonamingo RR, Bonfá R, Duro KM, Furian RD, Zelmanowicz AM. Early diagnosis of cutaneous melanoma: an observation in southern Brazil. An Bras Dermatol. 2011;86:215–221. - PubMed
    1. Grinblat M. Prevenção do Câncer de Pele [tese] São Paulo, (SP): Hospital Israelita Albert Einstein; 2003.

Publication types

LinkOut - more resources