The Diagnostic Accuracy of Dermoscopy for Basal Cell Carcinoma: A Systematic Review and Meta-Analysis

Publication date: Available online 21 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Ofer Reiter, Ilit Mimouni, Michael Gdalevich, Ashfaq Marghoob, Assi Levi, Emmilia Hodak, Yael Anne Leshem

Abstract

Background

Dermoscopy is a noninvasive technique for the diagnosis of skin lesions. Its accuracy for basal cell carcinoma (BCC) has not been systematically studied.

Objective

To systematically investigate the accuracy of dermoscopy for the diagnosis of basal cell carcinoma with comparison to naked eye examination.

Methods

A systematic review of studies reporting the accuracy of naked eye examination and dermoscopy for the diagnosis of BCC was conducted. A meta-analysis for sensitivity and specificity was performed using a bivariate mixed-effects logistic regression modeling framework.

Results

Seventeen studies were identified. The pooled sensitivity and specificity of dermoscopy for the diagnosis of basal cell carcinoma were 91.2% and 95%, respectively. In studies comparing test performance, adding dermoscopy to naked eye examination improved sensitivity from 66.9% to 85% (p=0.0001), and specificity, from 97.2% to 98.2% (p=0.006). The sensitivity and specificity of dermoscopy were higher for pigmented than non-pigmented BCC. Sensitivity increased when dermoscopy was performed by experts and when the diagnosis was based on in-person dermoscopy as opposed to dermoscopic photographs.

Limitations

Significant heterogeneity among studies with a medium-to-high risk of bias.

Conclusion

Dermoscopy is a sensitive and specific add-on tool for the diagnosis of basal cell carcinoma. It is especially valuable for pigmented BCC.

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