Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions
Introduction: The diagnosis of fully amelanotic skin tumors is difficult on clinical and dermoscopic examination. Objective: We sought to identify an accurate and user-friendly dermoscopic algorithm to differentiate between benign and malignant pink lesions. Methods: The database of 1 referral...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Mattioli1885
2025-01-01
|
| Series: | Dermatology Practical & Conceptual |
| Subjects: | |
| Online Access: | https://dpcj.org/index.php/dpc/article/view/4768 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832540715517739008 |
|---|---|
| author | Riccardo Pampena Stefano Migliorati Giovanni Paolino Michela Lai Nicola Lippolis Stefania Guida Stefania Borsari Sebastiano Pellerone Sofia Maria Di Ciaccio Elvira Moscarella Giovanni Pellacani Giuseppe Argenziano Caterina Longo |
| author_facet | Riccardo Pampena Stefano Migliorati Giovanni Paolino Michela Lai Nicola Lippolis Stefania Guida Stefania Borsari Sebastiano Pellerone Sofia Maria Di Ciaccio Elvira Moscarella Giovanni Pellacani Giuseppe Argenziano Caterina Longo |
| author_sort | Riccardo Pampena |
| collection | DOAJ |
| description |
Introduction: The diagnosis of fully amelanotic skin tumors is difficult on clinical and dermoscopic examination.
Objective: We sought to identify an accurate and user-friendly dermoscopic algorithm to differentiate between benign and malignant pink lesions.
Methods: The database of 1 referral center was retrospectively reviewed for images of non-inflammatory fully amelanotic skin lesions. Two dermatologists jointly assessed a validation set of images for dermoscopic criteria and constructed a diagnostic algorithm, the 2-step 7-pink rule (2S-7PR). Two external clinicians, with different skills in dermoscopy and blinded to the final diagnosis, separately evaluated images from the validation test sets using the prevalent criterion method and the new 2S-7PR algorithm.
Results: A total of 763 lesions from 652 patients were included in the validation set database, of which 68.3% were malignant and 31.7% were benign. Three suspicious dermoscopic criteria were included in the first step of the 2S-7PR: polymorphous or sharply focused vessels, scales or crusts, and erosions or ulcerations; and 4 non-suspicious criteria were included in the second: white collarette, white scar-like area, vascular lacunae, and necklace pinpoint vessels. High levels of specificity and sensitivity were calculated in the validation and test phases for both the expert and non-expert evaluators, the former achieving higher levels of both sensitivity and specificity by employing the 2S-7PR compared to the prevalent method, and the latter only improved specificity.
Conclusions: The present study showed that an algorithm focused on a few reproducible and easily recognizable criteria could improve diagnostic accuracy in the management of amelanotic lesions.
|
| format | Article |
| id | doaj-art-1fe6b0680d4845098cf49a038bd08647 |
| institution | Kabale University |
| issn | 2160-9381 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Mattioli1885 |
| record_format | Article |
| series | Dermatology Practical & Conceptual |
| spelling | doaj-art-1fe6b0680d4845098cf49a038bd086472025-02-04T15:41:35ZengMattioli1885Dermatology Practical & Conceptual2160-93812025-01-0115110.5826/dpc.1501a4768Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin LesionsRiccardo Pampena0Stefano Migliorati1Giovanni Paolino2Michela Lai3Nicola Lippolis4Stefania Guida5Stefania Borsari6Sebastiano Pellerone7Sofia Maria Di Ciaccio8Elvira Moscarella9Giovanni Pellacani10Giuseppe Argenziano11Caterina Longo12Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, ItalyAzienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, ItalyIRCCS Ospedale, San Raffaele, Milano, ItalyClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyAzienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milano, ItalyAzienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, ItalyDermatology Unit, University of Campania, Naples, ItalyDermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalyDermatology Unit, University of Campania, Naples, ItalyDermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalyDermatology Unit, University of Campania, Naples, ItalyAzienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy Introduction: The diagnosis of fully amelanotic skin tumors is difficult on clinical and dermoscopic examination. Objective: We sought to identify an accurate and user-friendly dermoscopic algorithm to differentiate between benign and malignant pink lesions. Methods: The database of 1 referral center was retrospectively reviewed for images of non-inflammatory fully amelanotic skin lesions. Two dermatologists jointly assessed a validation set of images for dermoscopic criteria and constructed a diagnostic algorithm, the 2-step 7-pink rule (2S-7PR). Two external clinicians, with different skills in dermoscopy and blinded to the final diagnosis, separately evaluated images from the validation test sets using the prevalent criterion method and the new 2S-7PR algorithm. Results: A total of 763 lesions from 652 patients were included in the validation set database, of which 68.3% were malignant and 31.7% were benign. Three suspicious dermoscopic criteria were included in the first step of the 2S-7PR: polymorphous or sharply focused vessels, scales or crusts, and erosions or ulcerations; and 4 non-suspicious criteria were included in the second: white collarette, white scar-like area, vascular lacunae, and necklace pinpoint vessels. High levels of specificity and sensitivity were calculated in the validation and test phases for both the expert and non-expert evaluators, the former achieving higher levels of both sensitivity and specificity by employing the 2S-7PR compared to the prevalent method, and the latter only improved specificity. Conclusions: The present study showed that an algorithm focused on a few reproducible and easily recognizable criteria could improve diagnostic accuracy in the management of amelanotic lesions. https://dpcj.org/index.php/dpc/article/view/4768melanoma, fully-amelanotic skin tumours, pink lesions, dermoscopy |
| spellingShingle | Riccardo Pampena Stefano Migliorati Giovanni Paolino Michela Lai Nicola Lippolis Stefania Guida Stefania Borsari Sebastiano Pellerone Sofia Maria Di Ciaccio Elvira Moscarella Giovanni Pellacani Giuseppe Argenziano Caterina Longo Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions Dermatology Practical & Conceptual melanoma, fully-amelanotic skin tumours, pink lesions, dermoscopy |
| title | Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions |
| title_full | Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions |
| title_fullStr | Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions |
| title_full_unstemmed | Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions |
| title_short | Two-step-7-Pink Rule: A Practical Tool for the Dermoscopic Evaluation of Fully Amelanotic Skin Lesions |
| title_sort | two step 7 pink rule a practical tool for the dermoscopic evaluation of fully amelanotic skin lesions |
| topic | melanoma, fully-amelanotic skin tumours, pink lesions, dermoscopy |
| url | https://dpcj.org/index.php/dpc/article/view/4768 |
| work_keys_str_mv | AT riccardopampena twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT stefanomigliorati twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT giovannipaolino twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT michelalai twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT nicolalippolis twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT stefaniaguida twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT stefaniaborsari twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT sebastianopellerone twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT sofiamariadiciaccio twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT elviramoscarella twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT giovannipellacani twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT giuseppeargenziano twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions AT caterinalongo twostep7pinkruleapracticaltoolforthedermoscopicevaluationoffullyamelanoticskinlesions |