Accuracy of diagnosis of melanoma and benign pigmented lesions on face, head and neck

Aim of the current study was evaluation of the accuracy of dermoscopy diagnostics of melanoma and benign pigmented lesions of patients who visited Clinical Centre of Skin and Sexually Transmitted Diseases, Riga 1st hospital in 12 months period of 2020. Comparison of the accuracy of dermoscopy results with histology was analyzed. In total 168 adults patients, 34-87 years of age, 107 female and 61 male who presented to the clinic with complaints about suspicious pigmented lesions for melanoma localized particularly on face, head or neck, were investigated applying method of dermoscopy with HEINE DELTA 20T dermatoscope. This in clinic routinely used dermatoscope provides clear, high-resolution images due to the high-quality achromatic optical system, allowing goggle function for switching between polarized and non-polarized illumination mode, with both glare-free and reflection-free view in LED light. From 168 patients with suspicious pigmented lesion for melanoma localized on face, head or neck, dermoscopy investigation confirmed melanoma in 9 cases – 6 with superficial melanoma, 2 with nodular melanoma and 1 lentigo maligna melanoma. Biopsies of these lesions were not performed due to risk of dissemination. From 9 patients sent from Clinical Centre of Skin and Sexually Transmitted Diseases to Out-patients’ clinic, Centre of Oncology of Latvia for treatment, surgical excision was performed and diagnosis of melanoma was confirmed histologically in 8 cases, histology result of 1 patient showed dysplastic nevus. Other 159 patients with suspicious pigmented lesions investigated with dermoscopy were - 110 seborrheic keratoses, 49 nevi, 8 solar lentigo, and 1 pyogenic granuloma. Manual dermoscopy is accurate and precise method in hands of expert, Biopsy to confirm diagnosis of melanoma on the face, head and neck is not recommendable; the excision of melanoma with safe margins is to be performed by maxillofacial surgeon. Collaboration among dermatologists, surgeons and pathologists improve treatment of melanoma.