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A New Quantitative Semiology

Lucio Andreassi, MD; Roberto Perotti, MD; Pietro Rubegni, MD; Marco Burroni, PhD; Gabriele Cevenini, PhD; Maurizio Biagioli, MD; Paolo Taddeucci, MD; Giordana Dell'Eva, PhD; Paolo Barbini, PhD

Arch Dermatol. 1999;135:1459-1465.

Objectives  To use a digital dermoscopy analyzer with a series of "borderline" pigmentary skin lesions (ie, clinically atypical nevi and early melanoma) to find correlation between the studied variables and to determine their discriminating power with respect to histological diagnosis.

Design  A total of 147 pigmentary skin lesions were histologically examined by 3 experienced dermatopathologists and identified as nevi (n = 90) and melanomas (n = 57). The system evaluated 36 variables to be studied as possible discriminant variables, grouped into 4 categories: geometries, colors, textures, and islands of color.

Setting  University medical department.

Patients  A sample of patients with excised pigmentary skin lesions (nevi and melanomas).

Main Outcome Measures  Sensitivity, specificity, and accuracy of the model for evaluating "borderline" pigmentary skin lesions.

Results  After multivariate stepwise discriminant analysis, only 13 variables were selected to compute the canonical discriminant function.

Conclusion  The present method made it possible to determine which objective variables are important for distinguishing atypical benign pigmentary skin lesions and early melanoma.

From the Departments of Dermatology (Drs Andreassi, Perotti, Rubegni, Burroni, Biagioli, and Taddeucci) and Cardiac Surgery and Biomedical Technology (Drs Cevenini and Barbini), University of Siena, and Biomedical Engineering Group (Dr Dell'Eva), Siena, Italy.

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