Reflectance confocal microscopy and features of melanocytic lesions: An internet-based study of the reproducibility of terminology Journal Article


Authors: Pellacani, G.; Vinceti, M.; Bassoli, S.; Braun, R.; Gonzalez, S.; Guitera, P.; Longo, C.; Marghoob, A. A.; Menzies, S. W.; Puig, S.; Scope, A.; Seidenari, S.; Malvehy, J.
Article Title: Reflectance confocal microscopy and features of melanocytic lesions: An internet-based study of the reproducibility of terminology
Abstract: Objective: To test the interobserver and intraobserver reproducibility of the standard terminology for description and diagnosis of melanocytic lesions in in vivo confocal microscopy. Design: A dedicated Web platform was developed to train the participants and to allow independent distant evaluations of confocal images via the Internet. Setting: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. Participants: The study population was composed of 15 melanomas, 30 nevi, and 5 Spitz/Reed nevi. Six expert centers were invited to participate at the study. Intervention: Evaluation of 36 features in 345 confocal microscopic images from melanocytic lesions. Main Outcome Measure: Interobserved and intraobserved agreement, by calculating the Cohen κ statistics measure for each descriptor. Results: High overall levels of reproducibility were shown for most of the evaluated features. In both the training and test sets there was a parallel trend of decreasing κ values as deeper anatomic skin levels were evaluated. All of the features, except 1, used for melanoma diagnosis, including roundish pagetoid cells, nonedged papillae, atypical cells in basal layer, cerebriform clusters, and nucleated cells infiltrating dermal papillae, showed high overall levels of reproducibility. However, less-than-ideal reproducibility was obtained for some descriptors, such as grainy appearance of the epidermis, junctional thickening, mild atypia in basal layer, plump bright cells, small bright cells, and reticulated fibers in the dermis. Conclusion: The standard consensus confocal terminology useful for the evaluation of melanocytic lesions was reproducibly recognized by independent observers. ©2009 American Medical Association. All rights reserved.
Keywords: controlled study; clinical feature; melanoma; confocal microscopy; epidermis; internet; basal cell; melanocytic nevus; cell junction; skin cell
Journal Title: Archives of Dermatology
Volume: 145
Issue: 10
ISSN: 0003-987X
Publisher: American Medical Association  
Date Published: 2009-10-01
Start Page: 1137
End Page: 1143
Language: English
DOI: 10.1001/archdermatol.2009.228
PROVIDER: scopus
PUBMED: 19841401
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: ARDEA" - "Source: Scopus"
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  1. Alon Scope
    125 Scope
  2. Ashfaq A Marghoob
    534 Marghoob
  3. Salvador Gonzalez Rodriguez
    203 Rodriguez