scholarly journals Diagnostic accuracy and interobserver concordance: teledermoscopy of 600 suspicious skin lesions in Southern Denmark

2020 ◽  
Vol 34 (7) ◽  
pp. 1601-1608 ◽  
Author(s):  
T. Vestergaard ◽  
S.C. Prasad ◽  
A. Schuster ◽  
R. Laurinaviciene ◽  
M.K. Andersen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Skin Lesions

scholarly journals Diagnostic Accuracy of Clinical and Microbiological Signs in Patients With Skin Lesions Resembling Buruli Ulcer in an Endemic Region

2018 ◽  
Vol 67 (6) ◽  
pp. 827-834 ◽  
Author(s):  
Miriam Eddyani ◽  
Ghislain E Sopoh ◽  
Gilbert Ayelo ◽  
Luc V C Brun ◽  
Jean-Jacques Roux ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Buruli Ulcer ◽  
Skin Lesions ◽  
Endemic Region

scholarly journals Introducing teledermoscopy of possible skin cancers in general practice in Southern Denmark

2020 ◽  
Vol 37 (4) ◽  
pp. 513-518
Author(s):  
Tine Vestergaard ◽  
Sumangali C Prasad ◽  
Annette Schuster ◽  
Rasa Laurinaviciene ◽  
Anette Bygum ◽  
...  
Keyword(s):  
General Practice ◽  
Diagnostic Accuracy ◽  
Health Care Systems ◽  
Final Diagnosis ◽  
Skin Lesions ◽  
University Hospital ◽  
Predictive Values ◽  
Face To Face ◽  
Skin Cancers ◽  
Care Systems

Abstract Background The increasing incidence of skin cancers poses a burden to health care systems. General practitioners (GPs) play an important role in triaging these diseases and referring relevant patients to specialists. It is challenging to distinguish benign from malignant skin lesions, and GPs may benefit from diagnostic support from teledermoscopy (TD). Objectives To assess whether the introduction of TD in general practice was feasible and might reduce the number of unnecessary referrals to specialists and to assess the diagnostic accuracy and confidence of participating GPs. Methods Fifty general practices in Southern Denmark participated. Adult patients presenting to their GP with suspected skin cancer could be included. Images including dermoscopy were taken by the GP and sent for evaluation by specialized dermatologists at a university hospital. Patients were simultaneously referred for a face-to-face evaluation at the university hospital. Diagnoses proposed by the GPs and by TD were compared to the final diagnoses obtained by histopathology or, if not available, face-to-face evaluation. Results Five hundred and nineteen patients with 600 suspected skin cancers were included. The final diagnosis was benign in 72.3%. The photo quality was good or fair in 90.5%. GPs reported uncertainty about their diagnoses in 41.5% of cases. The GPs’ positive predictive values for any malignancy and for malignant melanoma were 49.5% and 26.3%, respectively. On evaluation by TD, 31.5% of lesions did not need further in-person assessment. Conclusion Useful images of suspicious skin lesions were obtained from general practice, and GPs could benefit from TD to improve their diagnostic accuracy and confidence.

A teledermatological approach to enhance diagnostic accuracy in dermatohistopathology

2003 ◽  
Vol 9 (3) ◽  
pp. 135-139 ◽  
Author(s):  
R Schiener ◽  
H Pillekamp ◽  
L Weber ◽  
K Hartmann ◽  
R U Peter
Keyword(s):  
Diagnostic Accuracy ◽  
Digital Images ◽  
Skin Lesions ◽  
Definitive Diagnosis ◽  
Differential Diagnoses ◽  
Digital Photographs ◽  
Diagnostic Interpretation

We determined whether digital photographs of skin lesions could enhance diagnostic accuracy in dermatohistological evaluations. Two dermatohistopathologists examined 375 unsorted consecutive cases. On a standardized questionnaire they recorded whether the final diagnostic interpretation would be improved by the availability of digital images of the skin lesions. In 101 cases (27%) they said that digital photographs would be helpful. Subsequently, 30 histological analyses were performed with and without digital photographs of the skin lesions. Presentation of digital photographs reduced the number of differential diagnoses significantly, from a median of 3 to 2. Ratings of ability to make a single definitive diagnosis increased significantly with the presentation of digital photographs. Enhancement of information given by the digital images was scored a median of 6 (on a scale of 0–10, with higher scores reflecting greater enhancement). Digital photographs of skin lesions are likely to refine diagnostic accuracy in histopathology.

Clinical Recognition of Melanoma in Dermatologists and Nondermatologists

2016 ◽  
Vol 20 (6) ◽  
pp. 532-535 ◽  
Author(s):  
Michal J. Martinka ◽  
Richard I. Crawford ◽  
Shannon Humphrey
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
General Practitioners ◽  
Family Physicians ◽  
Skin Lesions ◽  
The Other ◽  
Training And Education ◽  
Clinical Diagnoses ◽  
Pathology Reports ◽  
Better Than

Background: The incidence of melanoma is increasing annually in Canada. Objectives: This retrospective study was designed to assess the ability of physicians of different specialties to accurately recognize melanoma. Methods: Pathology reports of biopsies submitted to Vancouver Coastal Health with clinical diagnoses of melanoma were reviewed (January to July 2013). The clinical diagnoses made by dermatologists, general practitioners and family physicians, and all other specialists were correlated with the final histopathologic diagnoses. Results: The dermatologists, general practitioners and family physicians, and all other specialists achieved diagnostic accuracies of 24.75%, 3.52%, and 12.75%, respectively. Conclusions: Although the diagnostic accuracy of dermatologists was significantly better than that the other practitioners, the majority of patients with suspicious skin lesions present to family physicians or general practitioners first. Thus, there is considerable value in providing more training and education to nondermatologists, because it can have a meaningful impact on patient care.

scholarly journals Translation of a Circulating microRNA Signature of Melanoma to a Novel Solid-Tissue Biomarker to Improve Diagnostic Accuracy and Reproducibility.

2021 ◽  
Author(s):  
Ryan Van Laar ◽  
Samuel King ◽  
Richard McCoy ◽  
Mirette Saad ◽  
Sian Fereday ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Digital Gene Expression ◽  
Disease Status ◽  
Skin Lesions ◽  
Disease Stage ◽  
Diagnostic Tools ◽  
Routine Practice ◽  
Circulating Microrna

Abstract Background Successful treatment of cutaneous melanoma depends on early and accurate diagnosis of clinically suspicious melanocytic skin lesions. Currently, histopathology examination of excised skin lesions is considered the ‘gold standard’ for diagnosis of melanoma. Multiple studies have shown the low accuracy and reproducibility of this method, underscoring the urgent need for new diagnostic tools, including disease-specific biomarkers. Previously, a 38-microRNA signature of melanoma (‘Mel38’) was previously identified in plasma and validated as novel circulating biomarker. In this study, Mel38 expression in solid biopsy tissue is examined to determine its ability to contribute to accurate and reproducible melanoma diagnoses.Methods Nanostring digital gene expression profiling was used to apply the Mel38 signature in a cohort of 308 formalin fixed paraffin embedded skin biopsies (‘Mel38’). Genomic data were interrogated using hierarchical clustering, univariate and multivariate statistical approaches. Mel38 classification scores (range 0 to 10) were compared to consensus histopathology results, including MPATH-DX class, AJCC disease stage, histological subtype as well as technical assay factors.Results The Mel38 score can identify high-risk melanomas (MPATH-Dx Class IV) from less-malignant forms of the disease with an area-under-the curve of 0.96 (P < 0.001). The genomic score ranges from 0 to 10 and is positively correlated with the melanoma progression, from benign naevi to metastatic disease (intraclass correlation coefficient: 0.85). Using a score threshold of > 2.3 identifies higher-risk melanomas, associated with poorer outcomes and more intensive suggested clinical actions. Multivariate analysis showed the score to be a significant predictor of malignancy, independent of technical and clinical covariates. Analysis of the Mel38 signature in spitz naevi reveal an intra-subtype profile, in common to both benign and malignant conditions.Conclusion Melanoma-specific circulating microRNAs maintain their association with malignancy when measured in the hypothesized tissue of origin. The Mel38 signature is an accurate and reproducible metric of melanoma status, based on changes in microRNA expression that occur as the disease develops and spreads. Inclusion of the Mel38 score into routine practice would give physicians a genomic assessment of a patient’s disease status. Combining molecular biomarker data with conventional histopathology data may improve diagnostic accuracy, reproducibility, and patient outcomes.

PCR performance for the diagnosis of cutaneous leishmaniasis caused by Leishmania viannia complex using biopsy samples, compared with exudate samples from skin lesions on filter paper

2020 ◽  
Vol 114 (10) ◽  
pp. 721-724
Author(s):  
Yahanda Gisela Apaza-Castillo ◽  
Elsa Gladys Aguilar-Ancori ◽  
Mercedes Maritza Quispe-Flórez ◽  
Max Carlos Ramírez-Soto ◽  
Rosa Luz Pacheco-Venero
Keyword(s):  
Skin Lesion ◽  
Diagnostic Accuracy ◽  
Skin Biopsy ◽  
Cutaneous Leishmaniasis ◽  
Filter Paper ◽  
Sampling Methods ◽  
Skin Lesions ◽  
Kappa Coefficient ◽  
Clinical Suspicion ◽  
Diagnostic Concordance

Abstract Background Cutaneous leishmaniasis (CL) is generally diagnosed by molecular methods, including PCR, using biopsy samples, skin scrapings and clinical exudates. In this study, we assessed the PCR performance for diagnosis of CL using skin of biopsy samples vs PCR of skin lesion exudate samples on filter paper and compared the diagnostic concordance of PCR using both sampling methods. Methods We assessed the PCR performance using 80 skin biopsy samples and 80 filter paper samples containing exudates from skin lesions obtained from 74 patients with clinical suspicion of CL in Cusco, Peru. Results : PCR using skin biopsy samples had superior diagnostic accuracy compared with filter paper PCR (62.5% [50/80] vs 38.7% [31/80], respectively; p˂0.005) and the diagnostic concordance between both sampling methods was ‘moderate’ (kappa coefficient=0.50, 95% CI 0.98 to 1.0). Conclusions PCR using biopsy samples remains the standard for diagnosis of CL.

Diagnostic accuracy in cases of skin lesions

2006 ◽  
Vol 4 (2) ◽  
pp. 198-199
Author(s):  
R. Betti ◽  
E. Inselvini ◽  
A. Lodi ◽  
C. Crosti
Keyword(s):  
Diagnostic Accuracy ◽  
Skin Lesions
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