A statistical analysis of the characteristics of pigmented skin lesions using epiluminescence microscopy

Due to the fact that not all pigmented skin lesions (PSL) can be diagnosed solely by their clinical appearance, additional criteria are required to optimize the clinical diagnosis of atypical nevus and melanoma. Epiluminescence microscopy is a noninvasive in vivo examination that often helps to improve the accuracy of clinical diagnosis of such lesions. Years of experience have indicated some differential epiluminescent patterns for benign and malignant PSL but there is some controversy about certain borderline lesions for which histological examination is always necessary. In our study we performed a statistical analysis of data concerning 183 PSL to determine characteristics significantly associated with these lesions allowing identification of epiluminescent criteria suggestive of atypical nevus and malignant melanoma. Using the chi-quadro test and stepwise regression logistic model, we identified the following epiluminescent pattern as a risk factor for atypical nevus and malignant melanoma: irregular pigment network, presence of capillaries, irregular and abrupt ending of overall pigmentation, irregular brown globules and irregular shape and size of black dots. (C) 1997 Elsevier Science B.V.