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Multicenter Study
. 2023 Apr;62(4):518-523.
doi: 10.1111/ijd.16573. Epub 2023 Jan 20.

Do not PASS any melanoma without diagnosis: a new simplified dermoscopic algorithm

José Antonio Avilés-Izquierdo  1 , Paloma García-Piqueras  1 , Cristina Ciudad-Blanco  1 , Belén Lozano-Masdemont  2 , Pablo Lázaro-Ochaita  3 , José María Bellón-Cano  4 , Enrique Rodríguez-Lomba  1
Affiliations
Multicenter Study

Do not PASS any melanoma without diagnosis: a new simplified dermoscopic algorithm

José Antonio Avilés-Izquierdo et al. Int J Dermatol. 2023 Apr.

Abstract

Introduction: Dermoscopic algorithms for melanoma diagnosis could be time-expending, and their reliability in daily practice lower than expected.

Objective: To propose a simplified dermoscopic algorithm for melanoma diagnosis.

Material and methods: A multicenter retrospective analysis of 1,120 dermoscopic images of atypical melanocytic tumors (320 melanomas and 800 non-melanomas) was performed. An algorithm based on polychromia, asymmetry in colors or structures, and some melanoma-specific structures was designed. Univariate and multivariate logistic regression analysis was calculated to estimate the coefficients of each potential predictor for melanoma diagnosis. A score was developed based on the dermoscopic evaluations performed by four experts blinded to histological diagnosis.

Results: Most melanomas had ≥3 colors (280; 84.5%), asymmetry in colors or structures (289; 90.3%), and at least one melanoma-specific structure (316; 98.7%). PASS score ≥3 had a 91.9% sensibility, 87% specificity, and 88.4% diagnostic accuracy for melanoma. PASS algorithm showed an area under the curve (AUC) of 0.947 (95% CI 0.935-0.959).

Limitations: This study was retrospective. A comparison between the performances of different dermoscopic algorithms is difficult because of their designs.

Conclusion: PASS algorithm showed a very good diagnostic accuracy, independently of the observers' experience, and it seems easier to perform than previous dermoscopic algorithms.

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