Carbone Anna, Ferrari Angela, Paolino Giovanni, Buccini Pierluigi, De Simone Paola, Eibenschutz Laura, Piemonte Paolo, Silipo Vitaliano, Sperduti Isabella, Catricalà Caterina, Frascione Pasquale
Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
Department of Dermatology, Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy.
Australas J Dermatol. 2017 Nov;58(4):286-291. doi: 10.1111/ajd.12595. Epub 2017 Jun 7.
BACKGROUND/OBJECTIVES: The clinical and dermoscopic differential diagnosis of flat pigmented facial lesions represents a great challenge for the clinicians. Our aim was to report a quantitative method based on dermoscopic features to better classify pigmented facial lesions.
This is a retrospective case-series study that analysed the dermoscopic features of 582 pigmented facial lesions.
The individual patient probability of lentigo maligna (LM) was predicted by a multivariate model, with an accuracy of 0.72. According to the odds ratio at the multivariate analysis, an individual scoring index was assigned to each criterion, and a value of 4.56 was identified as optimal cut-off point. Up to a score of 2.5, the probability that a lesion is an LM is 0. The probability increases from 10 to 50% for a score ranging between 4.5 and 6. It is about 90% for a score of 7.
The optimal cut-off point obtained and the curve that identifies the probability of a patient having a LM could improve the classification and the management strategies of equivocal pigmented facial lesions.
背景/目的：面部扁平色素性皮损的临床及皮肤镜鉴别诊断对临床医生而言是一项巨大挑战。我们的目的是报告一种基于皮肤镜特征的定量方法，以更好地对面部色素性皮损进行分类。
这是一项回顾性病例系列研究，分析了582例面部色素性皮损的皮肤镜特征。
通过多变量模型预测恶性雀斑样痣（LM）的个体患者概率，准确率为0.72。根据多变量分析的比值比，为每个标准分配一个个体评分指数，确定4.56为最佳切点值。得分高达2.5时，皮损为LM的概率为0。得分在4.5至6之间时，概率从10%增加到50%。得分为7时，概率约为90%。
所获得的最佳切点值以及确定患者患有LM概率的曲线可改善面部可疑色素性皮损的分类及管理策略。
