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Skin Ultrasonography and Color Doppler as a Diagnostic Technique for Non-Melanocytic Skin Tumors

Introduction: The introduction of new diagnostic imaging techniques in dermatology, such as cutaneous B-mode ultrasonography (ultrasound/ecography) with color doppler, could improve the diagnosis of non-melanocytic tumors, mainly of those that are intradermal and subcutaneous lesions. The overall objective of this study was to evaluate the validity and diagnostic accuracy of dermatologic highfrequency ultrasound as a test for diagnosing bening, melanocytic skin neoplasms. A more specific objective was to gauge the sensitivity and specificity of dermatologic ultrasound as measures of its own validity, by using the diagnostic-therapeutic biopsy as a gold standard test.

Materials and methods: This is a multicenter prospective cohort study, which involved 642 patients from 4 different Spanish cities, along with 6 participating hospitals, 6 medical-surgical dermatologists and dermatological ultrasound experts and 6 anatomical-pathologists (pathologists) that are also experts in dermatologic histopathology.

Results: The main objective of the estimated variables’ study was achieved, with a 95% Confidence Interval (CI). Ultrasound’s sensitivity to detect benign non-melanocytic skin lesions-0.93 (0.89, 0.14); ultrasound’s specificity to detect malignant non-melanocytic skin tumors-0.84 (0.79, 0.88); Positive Predictive Value (PPV)-0.84 (0.80, 0.88); Negative Predictive Value (NPV)-0.92 (0.88, 0.95); Positive Likelihood Ratio (PLR) or correct hit-ratio (correctly classified tumors)-5.66 (4.33, 7.38); Negative Likelihood Ratio (NLR) or incorrect hit-ratio (misclassified tumors)-0.09 (0.06, 0.14).

Conclusion: Dermatologic high-resolution ultrasound is a valid and safe enough test that can be used when diagnosing non-melanocytic skin tumors.

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