Janssen Laudine, Van Kelst Sofie, Diricx Bart, Kimpe Tom, Papeleu Jorien, Verhaeghe Evelien, Brochez Lieve, Garmyn Marjan
Department of Dermatology, KU Leuven, Belgium.
Barco healthcare, Kortrijk, Belgium.
Dermatol Pract Concept. 2023 Jan 1;13(1):e2023058. doi: 10.5826/dpc.1301a58.
The interpretation of colors is essential in the dermoscopic evaluation of skin lesions. The same blue color on white dermoscopy may indicate blood or pigment deep in the dermis. Contrary to white dermoscopy, multispectral dermoscopy uses different wavelengths of light to illuminate a lesion and is able to decompose the dermoscopic image into individual maps that allow to more clearly visualize specific skin structures such as pigment distribution (pigment map) and vasculature (blood map). These maps are called skin parameter maps.
The aim of this research is to investigate whether skin parameter maps can be used to objectively identify and distinguish the presence of pigment and blood, by using blue naevi and angiomas as models for respectively pigment and blood.
We retrospectively analyzed 24 blue naevi and 79 angiomas. The skin parameter maps of each of the lesions were independently reviewed by 3 expert dermoscopists, in the absence of the regular white-light dermoscopic image.
All the observers provided high levels of diagnostic accuracy for blue naevus and angioma based on skin parameter maps alone, and the dermoscopic diagnosis was considered substantially reliable because of the 79% of diagnostic K agreement. Percentages of blue naevi and angiomas that showed respectively deep pigment and blood were very high at 95.8% and 97.5%. There was a percentage of lesions that counterintuitively showed blood in blue naevi (37.5%) and deep pigment in angiomas (28.8%).
Skin parameter maps based on multispectral images can help to objectify the presence of deep pigment or blood in blue naevi and angiomas. The application of these skin parameter maps could help in the differential diagnosis between pigmented and vascular lesions.
颜色的解读在皮肤病变的皮肤镜评估中至关重要。在白色皮肤镜下呈现的相同蓝色可能表明真皮深层存在血液或色素。与白色皮肤镜不同，多光谱皮肤镜使用不同波长的光来照亮病变，并能够将皮肤镜图像分解为单独的图谱，从而更清晰地可视化特定的皮肤结构，如色素分布（色素图谱）和血管系统（血液图谱）。这些图谱被称为皮肤参数图谱。
本研究的目的是通过将蓝痣和血管瘤分别作为色素和血液的模型，研究皮肤参数图谱是否可用于客观识别和区分色素和血液的存在。
我们回顾性分析了24例蓝痣和79例血管瘤。3位专业皮肤镜医师在不参考常规白光皮肤镜图像的情况下，独立查看每个病变的皮肤参数图谱。
所有观察者仅基于皮肤参数图谱对蓝痣和血管瘤的诊断准确率都很高，由于诊断一致性系数（K值）为79%，皮肤镜诊断被认为基本可靠。分别显示深层色素和血液的蓝痣和血管瘤的百分比非常高，分别为95.8%和97.5%。有一定比例的病变出现了与直觉相反的情况，即蓝痣中显示血液（37.5%），血管瘤中显示深层色素（28.8%）。
基于多光谱图像的皮肤参数图谱有助于客观确定蓝痣和血管瘤中深层色素或血液的存在。这些皮肤参数图谱的应用有助于色素性和血管性病变的鉴别诊断。
