{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:27:10Z","timestamp":1790274430931,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dermoscopy enhances melanoma detection, but small\u2010diameter melanomas (SDMs) remain diagnostically challenging. Convolutional neural networks (CNNs) may detect subtle patterns beyond human perception. This study evaluates how lesion diameter influences the diagnostic accuracy of dermatologists, with and without CNN support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This multicenter cross\u2010sectional study included 150\u00a0histopathologically verified lesions: 110\u00a0small lesions (70\u00a0SDM, 40\u00a0nevi) and 40 large\u2010diameter melanomas (LDM &gt;\u00a05\u00a0mm). Dermatologists evaluated lesions at level: (I) dermoscopy, close\u2010up image, and clinical metadata; (II) plus CNN predictions. Primary outcomes were sensitivity, specificity, and ROC\u2010AUC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The CNN achieved a sensitivity of 62.7% (53.4%\u201371.2%), specificity of 80.0% (65.2%\u201389.5%), and ROC\u2010AUC of 0.800 (0.723\u20130.876). Dermatologists performed higher at 71.8% (62.8%\u201379.4%), 82.5% (68.1%\u201391.3%), and 0.853 (0.794\u20130.912), improving slightly with CNN support to 72.7% (63.7%\u201380.2%), 85.0% (70.9%\u201392.9%), and 0.860 (0.796\u20130.923) (all p\u00a0&gt;\u00a00.180). Subgroup analyses showed lower CNN performance in SDM, with sensitivity 48.6% (37.3%\u201360.1%) and ROC\u2010AUC 0.740 (0.644\u20130.836), compared with LDM at 87.2% (73.3%\u201394.4%) and 0.904 (0.836\u20130.973). Dermatologists also reached their highest ROC\u2010AUC in the LDM subgroup (0.925 [0.858\u20130.991]). Overall, CNN support led to slight, non\u2010significant improvements, most notably in SDM (all p\u00a0&gt;\u00a00.720).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lesion size strongly influences melanoma diagnosis. CNN support offers modest, non\u2010significant gains, with highest accuracy achieved by experts using AI assistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ddg.70409","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:55:01Z","timestamp":1786078501000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Small lesion, big challenge? Diagnosis of small diameter melanocytic lesions by dermatologists using AI support"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4200-9647","authenticated-orcid":false,"given":"Anastasia Sophie","family":"Vollmer","sequence":"first","affiliation":[{"name":"Department of Dermatology University medical Center Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-6497","authenticated-orcid":false,"given":"Gianluca","family":"Nazzaro","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Katharina","family":"Winkler","sequence":"additional","affiliation":[{"name":"Department of Dermatology University medical Center Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Argenziano","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Mental and Physical Health and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimilios","family":"Lallas","sequence":"additional","affiliation":[{"name":"First Department of Dermatology School of Medicine Faculty of Health Sciences Aristotle University  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2428-2658","authenticated-orcid":false,"given":"Katharina Susanne","family":"Kommoss","sequence":"additional","affiliation":[{"name":"Department of Dermatology University medical Center Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Blum","sequence":"additional","affiliation":[{"name":"Public Private and Teaching Practice for Dermatology  Konstanz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelm","family":"Stolz","sequence":"additional","affiliation":[{"name":"Department of Dermatology Allergology and Environmental Medicine II Hospital Thalkirchner Street  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Maronese","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Giacalone","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina B","family":"Spigariolo","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-5506","authenticated-orcid":false,"given":"Gabriele","family":"Roccuzzo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Section of Dermatology University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-2370","authenticated-orcid":false,"given":"Gianluca","family":"Avallone","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Section of Dermatology University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Guida","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Mental and Physical Health and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8982-9410","authenticated-orcid":false,"given":"Gabriella","family":"Brancaccio","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Mental and Physical Health and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Broganelli","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Section of Dermatology University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Surgical Medical Dental and Morphological Sciences Related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Farnetani","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Surgical Medical Dental and Morphological Sciences Related to Transplant Oncology and Regenerative Medicine University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Passoni","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2258-8357","authenticated-orcid":false,"given":"Angelo V","family":"Marzano","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy Department of Physiopathology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Enk","sequence":"additional","affiliation":[{"name":"Department of Dermatology University medical Center Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-3104","authenticated-orcid":false,"given":"Holger Andreas","family":"Haenssle","sequence":"additional","affiliation":[{"name":"Department of Dermatology University medical Center Heidelberg  Heidelberg 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