Lorentzen Henrik F, Eefsen Rikke Løvendahl, Weismann Kaare
The Naevus Clinic, Department of Dermatology, Odense University Hospital, DK-5000 Odense, Denmark.
Acta Derm Venereol. 2008;88(2):139-42. doi: 10.2340/00015555-0374.
Dermatoscopic asymmetry of melanocytic skin lesion is pivotal in most algorithms assessing the probability of melanoma. Larger lesions cannot be assessed by dermatoscopy and the Dermaphot in a single field of vision, but this can be performed using the acrylic globe magnifier. We examined the diagnostic accuracy of the acrylic globe magnifier and compared it with classical dermatoscopy. A total of 119 patients successively referred to our naevus clinics had Dermaphot and acrylic globe magnifier pictures taken. Lesions were excised and assessed by histopathology. Observers blinded to histopathology diagnoses, assessed dermatoscopic and acrylic globe magnifier photo-slides according to the dermoscopic risk stratification. The observed agreement over all categories between acrylic globe magnifier dermatoscopy and classical dermatoscopy was 94% and Cohen's kappa coefficient was 90% (95% confidence interval 83-97%). Sensitivity for melanoma, benign melanocytic naevi and basal cell carcinoma was 100%, 98% and 85%, respectively. Specificity was 95%, 94% and 100% for melanoma, naevi and basal cell carcinoma. Acrylic globe dermatoscopy enables a diagnostic accuracy similar to epiluminescence microscopy.
在大多数评估黑素瘤可能性的算法中，黑素细胞性皮肤病变的皮肤镜不对称性至关重要。较大的病变无法在单一视野中通过皮肤镜和皮肤摄影进行评估，但使用丙烯酸球放大镜可以做到这一点。我们检查了丙烯酸球放大镜的诊断准确性，并将其与传统皮肤镜进行了比较。共有119名相继转诊至我们痣门诊的患者拍摄了皮肤摄影和丙烯酸球放大镜照片。病变切除后进行组织病理学评估。对组织病理学诊断不知情的观察者，根据皮肤镜风险分层对皮肤镜和丙烯酸球放大镜照片幻灯片进行评估。丙烯酸球放大镜皮肤镜与传统皮肤镜在所有类别上观察到的一致性为94%，科恩kappa系数为90%（95%置信区间83-97%）。对黑素瘤、良性黑素细胞痣和基底细胞癌的敏感性分别为100%、98%和85%。黑素瘤、痣和基底细胞癌的特异性分别为95%、94%和100%。丙烯酸球皮肤镜的诊断准确性与落射荧光显微镜相似。
