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A descriptive study on the clinical, dermoscopic and histopathologic features of pigmented skin lesions among Filipino adults

Maria Cecilia P. Ingente, MD, FPDS, Katrina Carmela M. Belen, MD, FPDS,Ma. Jasmin J. Jamora, MD, FPDS, John Michael F. Dellariarte, MD, DPDS, Terese Monette O. Aquino, MD



Dermoscopy increases the diagnostic accuracy of clinical visual inspection by 5% to 30%. This has led to a reduction of unnecessary excision of benign skin lesions and the earlier diagnosis of malignant skin lesions.



To compare the concordance agreement of the clinical versus histopathologic diagnosis to the concordance agreement of the dermoscopic versus histopathologic diagnosis of pigmented lesions.


Research Design:

This is a prospective, cross-sectional study of the clinical, dermoscopic and histopathological features of pigmented skin lesions on patients seen at the Out-Patient Departments of Quirino Memorial Medical Center and Ospital ng Makati from March 2013 to June 2014.



Sixty-eight subjects fulfilled the criteria and were all included in the final analysis. Classification and definitive diagnosis of the lesion as benign or malignant were determined thru clinical, dermoscopic and histopathologic features by one dermatopathologist. Kappa and concordance analyses were performed to determine the statistical and concordance agreement among the results of the three diagnostic procedures, respectively.



The statistical agreement between clinical versus histopathologic classification as benign or malignant was good (kappa=0.872), while the statistical agreement was high (kappa=0.872) between dermoscopic versus histopathologic classification. Concordance agreement between clinical versus histopathologic diagnosis showed fair agreement (concordance coefficient=0.2397) as compared to a high agreement (concordance coefficient=0.98) in dermoscopic versus histopathologic diagnosis.



The use of dermoscopy in pigmented lesions aids the dermatologist in giving an accurate diagnosis without invasive procedures. Knowledge of the dermoscopic features will help in the early clinical detection and management of benign and malignant pigmented skin lesions


  1. Rigel DS, Carucci JA. Malignant melanoma: prevention, early detection, and treatment in the 21st century. CA Cancer J Clin. 2000; 50:215-36.
  2. Skin Cancer Statistics. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2010 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2013. Available at:
  3. Braun RP, French LE, Saurat JH. Dermoscopy of pigmented lesions: a valuable tool in the diagnosis of melanoa. Swiss Med Wkly. 2004;134:83-90.
  4. Alam M. Ratner D. Cutaneous Squamous-Cell Carcinoma. N Engl J Med. 2001;344:975-983.
  5. Vargo N. Basal Cell and squamous cell carcinoma. Semi Oncol Nurs. 2003 Feb;19(1):12-21.
  6. Carruci J, Leffell D. (2008). Basal Cell Carcinoma In K Wolff, L Goldsmith, S Kats, B Gilchrist, A Paller, D Leffell (Eds), Fitzpatrick’s Dermatology in General Medicine 7th edition (pp. 1036-1042) New York,NY:McGraw Hill.
  7. Rigel DS. Malignant melanoma: perspectives on incidence and its effects on awareness, diagnosis, and treatment. CA Cancer J Clin. 1996;46:195-8.
  8. Braun R, Rabinovitz H, Oliviero M, Kopf A, Saurat J. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol. 2005;52:109-21.
  9. Prieto VG, Argenyi ZB, Barnhill RL, et al. Are en face frozen sections accurate for diagnosing margin status in melanocytic lesions?. Am J Clin Pathol. 2003; 120:203208.
  10. Crotty KA, Menzies SW. Dermoscopy and its role in diagnosing melanocytic lesions: a guide for pathologists. Pathology. 2004 Oct;36(5): 470-7.
  11. Ahmadabad RN, Ghaninezhad H, Moslehi H, Azizahari S, Kamyab K, Nikoo A. Description of some dermatoscopic features of acral pigmented lesions in Iranian patients: a preliminary study. Acta Med Iranica. 2011:49(7): 472-477.
  12. Argenziano G, Zalaudek I. Dermoscopy: a new perspective. Dermatol Pract Concept. 2011;1(1):12.
  13. Blum A, Metzler G, Hofmann-Wellenhof R, Soyer HP, Garbe C, Bauer J. Correlation between dermoscopy and histopathology in pigmented and non-pigmented skin tumours. Hautarzt. 2003 Mar; 54(3): 279-291.
  14. Vano-Galvan S, de las Heras E, Aguayo-Leyva I. Dermatoscopy for in vivo diagnosis of malignant melanoma. Aust Fam Physician. 2009 June; 38(6):420-421.
  15. Pehamberger H, Binder M, Steiner A, Wolff K. In vivo epiluminescence microscopy: improvement of early diagnosis of melanoma. J Invest Dermatol. 1993 Mar;100(3):356S-362S.
  16. Caluya B, Carpio B, Morales E, Tiongco I, Tanglao-De Guzman A, Yason M. Teledermoscopy for the diagnosis of malignant pigmented lesions on Filipino Skin: A cross sectional study. Presented in: Philippines Dermatological Society Research Forum. 2012.
  17.  Ferrara G, Argenziano G, Soyer HP, Corona R, Sera F, Brunetti B. Dermoscopic and Histopathologic Diagnosis of Equivocal Melanocytic Skin Lesions: An Interdisciplinary Study on 107 Cases. Cancer. 2002;95(5):1094-1100.
  18. Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85:257-268.
  19. Argenziano G, Soyer HP. Dermoscopy of pigmented skin lesions – a valuable tool for early diagnosis of melanoma. Lancet Oncol. 2001;2:443–9.
  20. Marghoob A. (2012). Congenital melanocytic nevi In Marghoob A, Malvehy J, Braun R (Eds), Atlas of Dermoscopy 2nd edition (pp. 147-158) London,UK; Informa Healthcare.
  21. Martin, J, Bella-Navarroa R, Jordáab E. Vascular Patterns in Dermoscopy. Actas Dermosifiliogr. 2012;103(5):357-75.
  22. Braun RP, Rabinovitz H, Krischer J, Kreusch J, Oliviero M, Naldi L, Kopf A, Saurat J. Dermoscopy of Pigmented Seborrheic Keratosis: A Morphological Study. Arch Dermatol. 2002;138(12):1556-1560.
  23. Ahlgrimm-Siess V, Cao T, Oliviero M, Hofmann-Wellenhof R, Rabinovitz H, Scope A. The Vasculature of Nonmelanocytic Skin Tumors in Reflectance Confocal Microscopy, II: Vascular Features of Seborrheic Keratosis. Arch Dermatol. 2010;146(6):694-695.
  24. Trigoni A, Lazaridou E, Apalla Z, Vakirlis E, Chrysomallis F, Varytimiadis D, Ioannides D. Dermoscopic features in the diagnosis of different types of basal cell carcinoma: a prospective analysis. Hippokratia. 2012 Jan-Mar;16(1): 29–34.
  25. Zalaudek I, Giacomel J, Schmid K, Bondino S, Rosendahl C, Cavicchini S, Tourlaki A, Gasparini S, Bourne P, Keir J, Kittler H, Eibenschutz L, Catrical C, Argenziano G. Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: A progression model. J Am Acad Dermatol. 2012;66:58997.
  26. Kittler, Harald, et al. “Standardization of Terminology in Dermoscopy/Dermatoscopy: Results of the Third Consensus Conference of the International Society of Dermoscopy.” Journal of the American Academy of Dermatology, vol. 74, no. 6, 2016, pp. 1093–1106., doi:10.1016/j.jaad.2015.12.038.

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A descriptive study on the clinical, dermoscopic and histopathologic features of pigmented skin lesions among Filipino adults