Carapeba Murilo de Oliveira Lima, Alves Pineze Mariana, Nai Gisele Alborghetti
Department of Dermatology, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP 19050-680, Brazil.
Medical School, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, 19050-680, Brazil.
Clin Cosmet Investig Dermatol. 2019 Jun 5;12:403-414. doi: 10.2147/CCID.S208717. eCollection 2019.
Dermoscopy is a low-cost examination performed by a dermatologist and good for the diagnosis of pigmented lesions. However, dermoscopy diagnosis of lentigo maligna (LM) and lentigo maligna melanoma (LMM) is still questionable. The objective of this study was to evaluate whether dermoscopy is an effective diagnostic method to diagnose LM/LMM from other pigmented skin lesions, and to identify which are the most frequent dermoscopic criteria associated with LM/LMM For this systematic review and meta-analysis, we used the following descriptors: dermoscopy, lentigo maligna, lentigo maligna melanoma, histopathology; and the following databases to search for articles: Cochrane Collaboration, MEDLINE; PMC (PubMed Central) - NIH (National Institutes of Health), EMBASE (The Excerpt Medical Database), and SCISEARCH, from inception to March 30, 2018. The evaluation of studies was performed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2 tool. The PRISMA (Preferred Reporting Itens for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines were followed for data extraction. Also, we extracted from each study the dermoscopic criteria most commonly found in the lesions of LM/LMM. This systematic review included 15 articles for qualitative analysis (a total of 2,012 lesions evaluated) and 7 for meta-analysis. In the bivariate model the mean sensitivity was 0.824 and the mean specificity was 0.835. The area under the curve was 0.889. Rhomboid structures, pseudonetwork, and homogeneous areas were the most frequent dermoscopic criteria associated with LM/LMM. These findings suggest that dermoscopy has good accuracy in the diagnosis of LM/LMM.
皮肤镜检查是皮肤科医生进行的一种低成本检查，有助于色素性皮损的诊断。然而，皮肤镜对恶性雀斑样痣（LM）和恶性雀斑样痣黑色素瘤（LMM）的诊断仍存在疑问。本研究的目的是评估皮肤镜检查是否是一种从其他色素性皮肤损害中诊断LM/LMM的有效诊断方法，并确定与LM/LMM相关的最常见皮肤镜标准。对于这项系统评价和荟萃分析，我们使用了以下描述词：皮肤镜检查、恶性雀斑样痣、恶性雀斑样痣黑色素瘤、组织病理学；并使用以下数据库检索文章：Cochrane协作网、MEDLINE、PMC（PubMed Central）-NIH（美国国立卫生研究院）、EMBASE（医学文摘数据库）和SCISEARCH，检索时间从数据库建立至2018年3月30日。使用QUADAS（诊断准确性研究质量评估）-2工具对研究进行评估。数据提取遵循PRISMA（系统评价和荟萃分析优先报告条目）和MOOSE（流行病学观察性研究的荟萃分析）指南。此外，我们从每项研究中提取了LM/LMM皮损中最常见的皮肤镜标准。这项系统评价纳入了15篇文章进行定性分析（共评估2012个皮损），7篇文章进行荟萃分析。在双变量模型中，平均敏感性为0.824，平均特异性为0.835。曲线下面积为0.889。菱形结构、假网络和均匀区域是与LM/LMM相关的最常见皮肤镜标准。这些发现表明，皮肤镜检查在LM/LMM的诊断中具有良好的准确性。
