Background and objectives: Dermoscopy is an effective non-invasive diagnostic method that allows the examination of morphological features not detectable by the eye. Dermoscopy has potentially improved the diagnostic accuracy for skin lesions. This study aims to assess the sensitivity and specificity of Dermoscopy in diagnosing malignant and premalignant skin lesions and determining their dermoscopic pattern. Methods: This prospective observational study was carried out at the Dermatology Clinic of Imam Khomeini Hospital in Ahwaz with the participation of a total of 240 patients, clinically diagnosed with pigmented and non-pigmented skin lesions. Participants were examined with dermoscopy and the results were compared with histopathologic findings as the gold standard for diagnose of skin lesions. At the same time, the major dermoscopic patterns of prevalent skin lesions were investigated. Collected data was analyzed by means of SPSS® software. Results: In this study, a total of 240 lesions were evaluated in patients from 10 to 91 years of age. Of this, 69 cases (28.8%) were benign, 75 cases (31.3%) were premalignant, and 96 cases (40.0%) were malignant. BCC (32.9%), SK (16.7%), nevus (6.3%), and SCC (5.0%) were, respectively, the most prevalent types of skin lesions. There was a 75.4% accordance between the dermoscopy and biopsy results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy of dermoscopy in the diagnosis of malignant skin lesions were 85.42%, 70.59%, 80.40%, 77.42%, and 79.27% respectively (P=0.0001). The most prevalent dermoscopic pattern for benign lesions consisted of collarette scale/keratin plaque (26.9%), for premalignant lesions consisted of sharp border (28.0%), and for malignant lesions consisted of blue-gray ovoid nest (41.67%), leaf-like structure (41.67%), and ulceration (39.58%). Conclusion: Dermoscopy has high sensitivity and specificity for diagnosis of skin lesions, making this non-invasive real-time method a suitable diagnostic technique for routine dermatologic practices. It can also prove useful in the accurate diagnosis of suspicious lesions prior to conducting biopsy. Therefore, with the aid of dermoscopy, unnecessary invasive biopsy (skin excisions) can be avoided. Nevertheless, conducting additional studies on larger sample volumes is a future necessity.
Dermoscopy, Skin lesions, Histopathology, Diagnostic accuracy
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