Objective Digital Dermoscopy
Author : Marco Burroni, University of Siena, Siena, Italy


In recent years, many methods have been suggested for the inspection of moles oriented to the early diagnosis of melanoma. The traditional pattern analysis of dermoscopic images provides a very high accuracy but requires a high level of experience. The conclusion that an inexperienced dermatologist could be confused by the new semiology pushed many researchers to study new mechanicistic models through a non linear combination of criteria. The evaluation of pigmented skin lesions through subjective assessments, however, is often complex and not reproducible. Subjective quantifications based on crispy definitions, as employed for example in the ABCD rule and 7-Point checklist revealed some limits in the daily practice. However the dermoscopy itself provides a useful tool for the early diagnosis of melanoma and many expert dermatologists are using the pattern analysis which provides powerful inspection techniques able to reveal early diagnostic signals. Dermoscopy provides high accuracy and dermatologists become more familiar with this non-invasive technique. The experts in this field think that dermoscopy needs more standardization in the definitions. A possible solution could be the objective analysis. In order to overcome the problems due to the qualitative interpretation, methods based on the mathematical analysis of pigmented skin lesions have been recently developed. This scientific review relates to the results obtained through the models developed by M. Burroni, L. Andreassi, G. Dell'Eva, P. Rubegni and colleagues. Each paragraph of this site reports a link to the published papers. Our experience goes from the enhanced visual inspection to the aided diagnosis. Please note how many works focus on the objective definition and semiological studies more than on aided diagnosis: our main goal was, infact, to provide robust and reproducible variables able to scientifically assess the pigmentary disorders. Image quality, reliable measurements and reproducibility represent the starting point of our research.  It should be clear how the results related to the many studies performed using the DB-Mips System and  the many different papers indicate always very similar trends with a mean Sensitivity close to 97% and a Specificity higher than 85%. Here below the scientific abstracts concerning each topic and the PubMed links have been reported.

 Aided diagnosis : the origin
 Subjective versus objective
Limitations of the subjective assessments : ABCD, 7-Point checklist  and others
Which accuracy ?
 A new semiology
Aided diagnosis 
Automated diagnosis
Common mole ?
Atypical mole
Fast  live diagnosis 
MM screening
Dysplastic mole ?
Spitz mole 
The genetic influence 
Ocular melanoma Telemedicine

 Bibliography
 Contact 
 Sponsor
Unplugged wi-fi dermoscopy
 www.skinlesions.net

Author : Marco Burroni, University of Siena, Siena, Italy