Clinical Evaluation Versus Clinical Evaluation With Dermoscopy in Malignant Skin Neoplasms Diagnosis

The purpose of the study was to assess the effectiveness of diagnostic methods, i.e., clinical evaluation and dermoscopy in the detection of malignant skin neoplasms (MSNs).

Between December 2021 and August 2025, 161 skin lesions from 142 patients were analyzed, comparing clinical evaluation (51 cases) with clinical evaluation with dermoscopy (110 cases) for the diagnosis of MSNs, including malignant melanomas of the skin (MMs) and non-melanoma malignant skin neoplasms (NMMSNs).

In comparison to clinical evaluation, clinical evaluation with dermoscopy in the detection of all malignant skin neoplasms (33 cases) increased the sensitivity from 81.8% [95% confidence interval (CI)=52.3-94.9] to 90.9% (95% CI=72.2-97.5), the specificity from 75% (95% CI=59.8-85.8) to 85.2% (95% CI=76.3-91.2), and the diagnostic odds ratio (DOR) from 13.5 (95% CI=2.5-73.2) to 57.7 (95% CI=12-276.8) with the relative diagnostic odds ratio (RDOR)=4.27 (95% CI=0.43-42.9; p=0.217). After adding dermoscopy to clinical evaluation, the sensitivity increased from 80% (95% CI=37.6-96.4) to 92.3% (95% CI=66.7-98.6) in MMs diagnosis (18 cases) and from 83.3% (95% CI=43.6-97) to 88.9% (95% CI=56.5-98) in NMMSNs detection (15 cases). In clinical evaluation with dermoscopy, the DOR increased both in MMs diagnosis from 12 (95% CI=1.2-120.3) to 69.2 (95% CI=8.3-578.7) and in NMMSNs recognition from 15 (95% CI=1.6-144.2) to 46.1 (95% CI=5.3-400.5) with the RDOR 5.77 (95%CI=0.25-132.51; p=0.273) and 3.08 (95%CI=0.13-70.31; p=0.481), respectively.

The sensitivity, specificity, DOR, and RDOR increased with the use of dermoscopy in MSNs diagnosis, mainly in MMs cases. However, the advantage of dermoscopy was not as significant in NMMSNs cases.