Dal Pozzo et al. hebben een algoritme bedacht voor dermatoscopie bij melanoom, waarbij ze alleen scoren op 7 kenmerken:

1. Irregular pigment network (2 punten)
2. Regression-erythema (2 punten)
3. Unhomogeneity (2 punten)
4. Sharp margin (2 punten)
5. Pseudopods (1 punt)
6. Radial streaming (1 punt)
7. Gray-blue veil (1 punt)

Bij 3 punten is er verdenking op een melanoom. Met deze 7 kenmerken (dermatoscopy 7-item-checklist) bereikten ze een sensitiviteit van 94.6%, en een specificiteit van 85.5%.



Figure 1. Irregular pigment network shows broad mesh and varying features in the same lesions, melanoma, level II, thickness 0.23 mm.




Figure 2. Regression-erythema is a white pinkish depigmented area possibly with a few angiectases, melanoma, level II, thickness 0.59 mm.




Figure 3. Unhomogeneity is an asymmetrical or irregular distribution in the lesion of at least two dermoscopic features not necessarily predictive of malignancy. In this lesion globules and a pigment network show an asymmetrical distribution, melanoma, level II, thickness 0.62 mm.




Figure 4. Sharp margin: abrupt cessation of the dermoscopic features at the periphery of the lesion not < 1/4 of the margin, melanoma, level II, thickness 0.42 mm.




Figure 5. Pseudopods: this lesion presents irregularly distributed pseudopods, melanoma, level II, thickness 0.54 mm.




Figure 6. Radial streaming are thin, closely spaced, parallel pigmented streaming irradiating from the rim of the lesion, melanoma, level II, thickness 0.20 mm.




Figure 7. Gray-blue veil: a blue or gray-faded blue area with ill-defined margins, asymmetrically located inside the lesion, melanoma, level II, thickness 0.98 mm.












Auteur(s):
dr. Jan R. Mekkes. Dermatoloog, Amsterdam UMC.