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A Novel Non-Invasive Scoring System for Differentiating DFSP and Keloids
Asako Iida1, Hiroaki Kuwahara1, Satoshi Akaishi1
1Department of Plastic and Reconstructive Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.
Archives of Plastic Surgery
|August 12, 2026
Summary
A new non-invasive method using the Japan Scar Workshop Scar Scale (JSS) and cosine of the angle (cosθ) effectively differentiates dermatofibrosarcoma protuberans (DFSP) from keloids. This JSS × cosθ scoring system offers a safe alternative to biopsy for diagnosing these skin conditions.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Distinguishing dermatofibrosarcoma protuberans (DFSP) from keloids is clinically challenging.
- Skin biopsies are often contraindicated due to risks of lesion exacerbation.
- A novel non-invasive diagnostic approach is needed.
Purpose of the Study:
- To introduce and validate a new non-invasive diagnostic method for differentiating DFSP from keloids.
- To assess the efficacy of the Japan Scar Workshop Scar Scale (JSS) combined with the cosine of the angle (cosθ) for differential diagnosis.
Main Methods:
- A case-control study involving retrospective analysis of 43 cases.
- Application of a novel evaluation method: JSS × cosθ.
- Non-invasive assessment of lesion characteristics using JSS and cosθ.
Main Results:
- The JSS × cosθ scoring system demonstrated significant ability to differentiate between DFSP and keloids (p < 0.001).
- Scores ≥16 were indicative of keloids.
- Scores <16 suggested DFSP.
Conclusions:
- The JSS × cosθ scoring system is a reliable and safe tool for distinguishing DFSP from keloids.
- This non-invasive method is particularly valuable when biopsies are contraindicated.
- The findings have significant implications for the management of DFSP and keloids.
