A SENSITIVITY AND SPECIFICITY ANALYSIS OF THE SURFACE MICROSCOPY FEATURES OF INVASIVE MELANOMA

In vivo cutaneous surface microscopy, epiluminescence microscopy, derm oscopy, dermatoscopy and magnified oil immersion diascopy, are terms t hat describe the use of an incident light magnification system to exam ine cutaneous lesions, usually with immersion oil at the skin-microsco pe interface. The result is the visualization of a multitude of morpho logical features, not visible with the naked eye, that enhance the cli nical diagnosis of nearly all pigmented lesions, Sixty-two invasive me lanomas and 159 randomly selected non-melanoma pigmented lesions were used In the study, The non-melanomas, while randomly selected from a l arge data base, were all clinically atypical. Using the x 10 magnifica tion of hand-held surface microscopes (Dermatoscope, Episcope), we pre sent an analysis of 72 surface microscopic variables (constituting ove r 15,000 single observations) for the diagnosis of invasive melanoma. Forty of the 72 features studied were shown to differ significantly be tween invasive melanoma and non-melanoma pigmented lesions. Blue-white veil, multiple brown dots, radial streaming and pseudopods had a spec ificity greater than 95% for melanoma. Two features, symmetrically irr egular pigment (non-uniform pigmentation with point and axial symmetry ) and the presence of a single colour, had a sensitivity of 0%, i.e. w ere absent, in melanoma. The other significant features are presented, with their sensitivity and specificity for melanoma.