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
ISSN 1450-708

Content
7 /2004
 
IMPORTANCE OF DERMOSCOPY IN MELANOMA DIAGNOSTICS
Bandiæ J.

ORS Hospital, Belgrade, Serbia and Montenegro
 
  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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© Academy of Studenica, 2004