Is dermoscopy a good tool for the diagnosis of lentigo maligna and lentigo maligna melanoma? A meta-analysis
Authors Carapeba MOL, Alves Pineze M, Nai GA
Received 14 March 2019
Accepted for publication 26 April 2019
Published 5 June 2019 Volume 2019:12 Pages 403—414
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jeffrey Weinberg
Murilo de Oliveira Lima Carapeba,1,2 Mariana Alves Pineze,2 Gisele Alborghetti Nai2,3
1Department of Dermatology, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP 19050-680, Brazil; 2Medical School, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, 19050-680, Brazil; 3Department of Pathology, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, 19050-680, Brazil
Introduction: Dermoscopy is a low-cost examination performed by a dermatologist and good for the diagnosis of pigmented lesions. However, dermoscopy diagnosis of lentigo maligna (LM) and lentigo maligna melanoma (LMM) is still questionable. The objective of this study was to evaluate whether dermoscopy is an effective diagnostic method to diagnose LM/LMM from other pigmented skin lesions, and to identify which are the most frequent dermoscopic criteria associated with LM/LMM
Methods: For this systematic review and meta-analysis, we used the following descriptors: dermoscopy, lentigo maligna, lentigo maligna melanoma, histopathology; and the following databases to search for articles: Cochrane Collaboration, MEDLINE; PMC (PubMed Central) - NIH (National Institutes of Health), EMBASE (The Excerpt Medical Database), and SCISEARCH, from inception to March 30, 2018. The evaluation of studies was performed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2 tool. The PRISMA (Preferred Reporting Itens for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines were followed for data extraction. Also, we extracted from each study the dermoscopic criteria most commonly found in the lesions of LM/LMM.
Results: This systematic review included 15 articles for qualitative analysis (a total of 2,012 lesions evaluated) and 7 for meta-analysis. In the bivariate model the mean sensitivity was 0.824 and the mean specificity was 0.835. The area under the curve was 0.889. Rhomboid structures, pseudonetwork, and homogeneous areas were the most frequent dermoscopic criteria associated with LM/LMM.
Conclusion: These findings suggest that dermoscopy has good accuracy in the diagnosis of LM/LMM.
Keywords: melanoma, diagnosis, systematic review, histopathology, biopsy
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