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Dermoscopic Findings in Intraepidermal Carcinoma: an Interobserver Agreement Study.

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Dermoscopic evaluation of intraepidermal carcinoma (IEC) in fair-skinned individuals revealed common findings like scales and vessels, but interobserver agreement was low. Standardized terminology is needed for accurate IEC diagnosis.

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Area of Science:

  • Dermatology
  • Dermoscopy
  • Oncology

Background:

  • Dermoscopic findings in intraepidermal carcinoma (IEC) lack standardized terminology, complicating clinical diagnosis.
  • Previous evaluations of IEC dermoscopy have rarely focused on fair-skinned populations.

Purpose of the Study:

  • To assess interobserver agreement among dermatologists for dermoscopic findings in IEC.
  • To determine the frequency of these dermoscopic findings in a predominantly fair-skinned population.

Main Methods:

  • 100 dermoscopic images of histopathologically confirmed IECs were analyzed.
  • A consensus meeting redefined 11 common dermoscopic findings using new terminology.
  • Eight experienced dermoscopists evaluated images, and data on frequency and agreement were analyzed.

Main Results:

  • Scales (83%), dotted/glomerular vessels (77%), pinkish-white areas (73%), and hemorrhage (46%) were most frequent.
  • Vascular structures (vessels/hemorrhage) were present in 89% of lesions.
  • Interobserver agreement was generally poor to moderate, with scales (0.55) and hemorrhage (0.54) showing the highest agreement.

Conclusions:

  • Dermoscopic findings in IEC, including pigmented structures, are consistent in fair-skinned populations.
  • Low interobserver agreement highlights the need for standardized terminology.
  • The proposed terminology and findings aim to guide researchers and clinicians in identifying IEC.