Institute of Dermatology, Catholic University, Rome, Italy.
Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dermatology. 2022;238(5):986-995. doi: 10.1159/000523953. Epub 2022 Apr 22.
Cutaneous melanoma accounts for the majority of skin cancer-related deaths. Readily identifiable phenotypic characteristics and total body nevus count (TBNC) >50 are among the most important risk factors for cutaneous melanoma. Implementation of nevus self-count procedures and self-assessment of phenotypic traits as part of skin self-examination could be an excellent screening tool for identifying an at-risk target population.
Objectives of the study were to assess the skills of a central Italian and eastern Spanish population sample to recognize their skin lesions via the submission of a self-assessment questionnaire and to explore which self-assessment questionnaire item combination best predicts the high-risk condition of TBNC >50.
Patients aged ≥18 years filled a self-assessment questionnaire, autonomously and prior to the dermatological visit. Subsequently, dermatologists performed total body skin examination and reported patients' skin lesions on a separate questionnaire.
We reported fair to moderate patient-dermatologist agreement for skin lesion self-assessment. The item number of nevi on the back was the single questionnaire item most accurately predicting TBNC >50. The high-sensitivity and high-specificity classification and regression tree models for the prediction of TBNC >50 displayed different items combinations; the item nevus on the back was always the first and most important predictor in both our models.
Patients were partially able to provide correct estimation of their whole-body nevus self-count. The item nevi on the back seems to be the first and most important predictor of TBNC >50 across our models. Delivery of high-sensitivity and high-specificity prediction models based on our questionnaire item combination may help defining a high-risk target population.
皮肤黑色素瘤是导致大多数皮肤癌相关死亡的原因。易于识别的表型特征和全身痣计数（TBNC）>50 是皮肤黑色素瘤最重要的危险因素之一。实施痣自我计数程序和自我评估表型特征作为皮肤自我检查的一部分，可以成为识别高危目标人群的极好筛查工具。
本研究的目的是评估意大利中部和西班牙东部人群样本识别自身皮肤病变的能力，通过提交自我评估问卷，并探讨哪种自我评估问卷项目组合最能预测 TBNC>50 的高危情况。
年龄≥18 岁的患者填写自我评估问卷，在皮肤科就诊前自主完成。随后，皮肤科医生对患者进行全身皮肤检查，并在单独的问卷上报告患者的皮肤病变。
我们报告了患者与皮肤科医生对皮肤病变自我评估的中等至中等偏下的一致性。背部痣的数量是预测 TBNC>50 最准确的单一问卷项目。用于预测 TBNC>50 的高灵敏度和高特异性分类回归树模型显示了不同的项目组合；背部痣是我们两个模型中始终是第一个也是最重要的预测因子。
患者能够部分正确估计他们的全身痣自我计数。背部痣似乎是我们两个模型中 TBNC>50 的第一个也是最重要的预测因子。基于我们问卷项目组合提供高灵敏度和高特异性的预测模型，可能有助于确定高危目标人群。
