Computer-aided diagnosis of melanocytic lesions.

BACKGROUND: The clinical diagnosis of melanoma could be difficult for a general practitioner and, in some cases, for dermatologists. To enhance and support the clinical evaluation of pigmented skin lesions a computer-aided diagnosis has been introduced. MATERIALS AND METHODS: Images of melanocytic lesions (477 total, 42 melanomas and 435 melanocytic nevi) evaluated in epiluminescence microscopy and recorded with x16 magnification were selected. A training set of 22 melanomas and 218 nevi was randomized from the dataset. The test set was formed by the complement (the remaining 20 melanomas and 217 nevi). Furthermore, a set of images consisting of 31 melanomas and 103 nevi was selected to compare the discrimination capacity of three general practitioners and three dermatologists with experience in dermoscopy (2 years), and with the automatic data analysis for the melanoma early detection system (ADAM). Sensitivity and specificity were estimated for observer assessments and computer diagnosis. RESULTS: The entire dataset used to test the implementation of the diagnostic algorithms ADAM showed a good sensitivity and specificity performance. Compared with the physicians, the ADAM system showed a slightly higher diagnostic performance in terms of sensitivity and a lower one in terms of specificity. Dermatologists showed higher levels of specificity, but lower levels in terms of sensitivity, when compared with the general practitioners. CONCLUSION: Image analysis has the potential to distinguish nevi and melanomas and to support the clinical diagnosis of melanocytic lesions by the general practitioner.

Eyelid dermatitis: an evaluation of 447 patients.

BACKGROUND: Eyelids can be affected by various types of dermatitis that are often difficult to diagnose. OBJECTIVE: The aim of the study was to establish some guidelines for a correct diagnosis. METHODS: A total of 447 patients treated at 12 research units for eczema or other inflammatory dermatitis located on the eyelids were invited to complete a questionnaire. When necessary, patch tests with haptens of the standard series from Gruppo Italiano di Ricerca sulle Dermatiti da Contatto e Ambientali della Società Italiana di Dermatologia e Venereologia (SIDEV-GIRDCA) were performed. RESULTS: Of the subjects studied, 50.2 % were diagnosed with allergic contact dermatitis (ACD); 20.9% were affected by irritant contact dermatitis (ICD), 13.5% by atopic dermatitis, 6.3% by seborrheic dermatitis, 6.5% by aspecific xerotic dermatitis, and 2.3% by psoriasis. Approximately 91% of all subjects reported an absence of familial atopy. A significant statistical association between diagnosis type and a personal history of atopy was evident (p <.000001, chi-square test). The results of gradual logistic regression models showed four-eyelid involvement as the main risk factor for ACD (odds ratio [OR] = 3.0; 95% CI, 1.1-8.1); with ICD, the main risk factor was the onset of symptoms at between 2 and 6 months (OR = 2.1; 95% CI, 1.1-4.0), whereas for atopic dermatitis, the main risk factors were the onset of symptoms later than 6 months and a personal history of atopy (OR = 4.9 and 3.6, respectively). CONCLUSION: Results suggest that many characteristics of the patients examined can be used for the differential diagnosis of palpebral eczematous dermatitis.