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Australas J Dermatol. 2017 Nov;58(4):286-291. doi: 10.1111/ajd.12595. Epub 2017 Jun 7.

Lentigo maligna of the face: A quantitative simple method to identify individual patient risk probability on dermoscopy.

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Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
Department of Dermatology, Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy.
Department of Biostatistics, Regina Elena National Cancer Institute, Rome, Italy.



The clinical and dermoscopic differential diagnosis of flat pigmented facial lesions represents a great challenge for the clinicians. Our aim was to report a quantitative method based on dermoscopic features to better classify pigmented facial lesions.


This is a retrospective case-series study that analysed the dermoscopic features of 582 pigmented facial lesions.


The individual patient probability of lentigo maligna (LM) was predicted by a multivariate model, with an accuracy of 0.72. According to the odds ratio at the multivariate analysis, an individual scoring index was assigned to each criterion, and a value of 4.56 was identified as optimal cut-off point. Up to a score of 2.5, the probability that a lesion is an LM is 0. The probability increases from 10 to 50% for a score ranging between 4.5 and 6. It is about 90% for a score of 7.


The optimal cut-off point obtained and the curve that identifies the probability of a patient having a LM could improve the classification and the management strategies of equivocal pigmented facial lesions.


dermoscopy; lentigo maligna; lichen planus-like keratosis; pigmented actinic keratosis; pigmented facial lesions; solar lentigo

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