Fougelberg Julia, Luong Alfred, Bowling Jonathan, Chamberlain Alex, Lallas Aimilios, Marghoob Ashfaq, Polesie Sam, Salerni Gabriel, Tanaka Masaru, Zaar Oscar, Zalaudek Iris, Claeson Magdalena, Paoli John
Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden.
Dermatol Pract Concept. 2023 Jan 1;13(1):e2023114. doi: 10.5826/dpc.1301a114.
A wide range of descriptive terms have been used for dermoscopic findings in intraepidermal carcinoma (IEC) and the clinical diagnostic accuracy of IEC can be challenging. Furthermore, dermoscopic findings in IEC have only rarely been evaluated in fair-skinned populations.
To measure the interobserver agreement between dermatologists for dermoscopic findings in IEC. Furthermore, to describe the frequency of these findings in a predominantly fair-skinned population.
One hundred dermoscopic images of histopathologically verified IECs were collected. The 11 most common dermoscopic findings described in previous studies were re-defined in a new terminology in a pre-study consensus meeting. Images were assessed by eight experienced international dermoscopists. The frequency of findings and the interobserver agreement was analyzed.
Scales (83%), dotted/glomerular vessels (77%), pinkish-white areas (73%) and hemorrhage (46%) were the most commonly present dermoscopic findings. Pigmented structures were found in 32% and shiny white structures (follicular or stromal) in 54% of the IEC. Vascular structures (vessels and/or hemorrhage) could be seen in 89% of the lesions. Overall, the interobserver agreement for the respective dermoscopic findings was poor to moderate, with the highest kappa values noted for scales (0.55) and hemorrhage (0.54) and the lowest for pinkish-white areas (0.015).
Our results confirm those of previous studies on dermoscopy in IEC, including the frequency of pigmented structures despite the fair-skinned population. The interobserver agreement was relatively low. The proposed new terminology and our findings can hopefully serve as a guideline for researchers, teachers and students on how to identify IEC.
表皮内癌（IEC）的皮肤镜表现有多种描述性术语，IEC的临床诊断准确性可能具有挑战性。此外，在白种人群中对IEC皮肤镜表现的评估很少。
测量皮肤科医生对IEC皮肤镜表现的观察者间一致性。此外，描述这些表现在以白种人为主的人群中的出现频率。
收集100张经组织病理学证实的IEC皮肤镜图像。在一项预研究共识会议上，用新术语重新定义了先前研究中描述的11种最常见的皮肤镜表现。由8名经验丰富的国际皮肤镜专家评估图像。分析表现的频率和观察者间一致性。
鳞屑（83%）、点状/肾小球样血管（77%）、粉白色区域（73%）和出血（46%）是最常见的皮肤镜表现。32%的IEC中发现色素沉着结构，54%的IEC中发现亮白色结构（毛囊或基质）。89%的病变中可见血管结构（血管和/或出血）。总体而言，观察者间对各皮肤镜表现的一致性为差到中等，鳞屑（0.55）和出血（0.54）的kappa值最高，粉白色区域最低（0.015）。
我们的结果证实了先前关于IEC皮肤镜检查的研究结果，包括尽管是白种人群，但色素沉着结构的出现频率。观察者间一致性相对较低。所提出的新术语和我们的发现有望为研究人员、教师和学生识别IEC提供指导。
