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10th
International Inter University Scientific Meeting
Academy of Studenica
PERSPECTIVES
IN MELANOMA MANAGEMENT
& NANOTECHNOLOGY IN BIOMEDICINE
Organizers:
Institute of Oncology
Sremska Kamenica; Union of Cancer Prevention
Societies of Vojvodina, Novi Sad; Clinic of Oncology, Nis; Institute
for Oncology and Radiology of Serbia, Belgrade Center for Bioengineering,
Faculty of Mechanical Engineering, University of Belgrade
President:
Vladimir Baltic Vice-presidents: Zlata
Janjic, Radan Dzodic, Borislava Nikolin; Djuro Koruga
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IMPORTANCE
OF DERMOSCOPY IN MELANOMA DIAGNOSTICS
Bandiæ
J.
ORS Hospital,
Belgrade, Serbia and Montenegro
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ABSTRACT
The
first works on dermoscopy are related to the year of 1987, when
Pehamberger, Steiner and Wolff published their study on in vivo
microscopy, with the usage of the immersion oil on more than 3000
pigmented skin lesions, and using the first established systematic
model in diagnostics that they called " the pattern analysis". Since
then until present the method has been improved both from the technical
and analytical aspect. Taking into consideration the technical aspect
of improvement, from the "simple dermatoscopy" where the examiner
used the hand microscope, the method has evaluated to the high digital
computer dermoscopy. However the most important modifications from
the analytical aspect happened: in 1994, when Stolz and his colleagues
published the new diagnostic algorithm with semi-quantitative score
for diagnosis of pigmented lesions on the skin, at the same time
under the name "ABCD rules of dermatoscopy", then in 1996 Menzies
published his personal method, and in 1998 Argenziano published
his 7-point checklist. The method is also evaluated terminologically
from ELM (epiluminescence microscopy), through dermatoscopy until
it got the final name, such as DERMOSCOPY (The first World Congress
of Dermoscopy, Rome, 2001). During its present development, dermoscopy
has been established in diagnostics of melanocyte lesion and melanoma,
but also in the diagnostics of non-melanoma lesions, such as basal
cell carcinoma, seboroic kerathosis, vascular lesions and dermatofibroma.
The accuracy of the dermoscopy, comparing to the histology-pathologic
diagnosis was from 80% at the beginning until present 92-98% (depending
on the author), at the melanocyte lesions cases.
In Serbia the beginning of work on dermoscopy is tied to the month
of August 1998, when the first dermoscopy system was installed in
CKT (The Centre for skin tumors, Pancevo).
The importance of dermoscopy in diagnostics of melanoma will be
presented through the prospective comparative study on dermoscopy,
clinic and histology-pathologic diagnoses of the pigmented lesions
on the skins, as well as melanoma in the period of August 1998 to
August 2003. The clinic diagnosis was identified, based on the ABCD
rules of self-check ups and the Glasgow range scale. The dermoscopy
diagnosis was identified also, based on the ABCD regulations for
dermoscopy and diagnostic algorithm between melanocyte and non-melanocyte
lesions. All those removed lesions are histology- pathologically
analyzed. The thorough study includes 1414 patients with 4653 of
derma-scope lesions, where 545 melanocyte lesions after having been
removed were histology -pathologically analyzed. 68 melanoma were
identified.
The accurate clinic diagnosis was as follows: of the total number
of 48 cases (70,6%) the false positive is 54 (70,9%), and false
negative 20 (29,4%). The dermoscopy diagnosis was accurate in 65
cases (95,6%). Therefore the dermoscopy diagnosis was accurate in
65 cases (95,6%), with no false positive results, where in three
cases(4,4%) the result was false negative one.
And finally, by comparing the results of the clinic and dermoscopy
diagnosis relating to the histology-pathologic diagnosis of the
melanoma, it can be notified much more accuracy with the dermoscopy
diagnosis.
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