Diagnosis of melanocytic skin lesions is often matter of considerable debate even among histopathologists. Dermoscopy can be viewed as the practical link of histopathology (micro-cosmos) with clinical dermatology (macro-cosmos). Like clinical dermatology, dermoscopy works parallel to the skin surface and perpendicular to the histologic plane; like the histopathology, thus it allows the viewing of structures not discernible by the naked eye.
This study included 50 patients with pigmented skin lesions. They were examined clinically, dermoscopically and histopatholgically, aiming at finding the efficacy of dermoscopy in their diagnosis. Our obtained results showed that there were 10 cases of benign nevi, 8 cases of post-inflammatory hyperpigmentation, 5 cases of seborrheic keratosis, 2 cases with freckles, actinic lichen, actinic keratosis and pigmented fibroepithelial polyp and one case for melasma, Lentigo simplex and papular mucinosis. The remaining 6 cases were reported to be malignant melanoma (2 cases), basal cell carcinoma (2 cases), mycosis fungoides (1 case) and Kaposi sarcoma (1 case).
This study showed that dermatoscopic evaluation has an important role in the diagnosis of benign pigmented skin lesions and avoiding the need of excision or biopsy. It also helps in the diagnosis of malignant melanoma and basal cell carcinoma with high degree of accuracy when compared with histopathologic examination.
Our study reported that the specificity and the positive predictive value of dermoscopy in diagnosis of pigmented skin lesions were 100% in spite of the limited number of the studied cases which should be more in the next studies. The sensitivity of dermoscopy was reported to be 66% in the same field, while the negative predictive value was found to be 95.6%. |
