{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:16:33Z","timestamp":1785428193915,"version":"3.56.0"},"reference-count":12,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Aiming to understand whether the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose a melanoma when analysing a given lesion <jats:italic>in toto versus<\/jats:italic> a partial analysis, with only the EH or the non\u2010hyperpigmented portion (non\u2010EH) visible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Dermatoscopic images of 240 lesions (107 melanomas and 133 nevi) typified by EH were selected. Facial, acral, mucosal lesions and lesions showing clear\u2010cut features of melanoma (except for atypical network) were excluded. Clinical and dermoscopic features (main pattern and numbers of colours) were described for all cases. Each image was split in two through a software so that only the EH or the non\u2010EH was visible. Two blinded evaluators examined three sets of images, two with customized images and one with the non\u2010modified ones: they were asked to give a dichotomous diagnosis (melanoma or nevus) for each image.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Melanomas were significantly more frequently typified by colour variegation (3 colours in 44.8% and 4 colours in 41.1% of cases) and atypical network (88.1% in the EH). No significant differences in diagnostic accuracy emerged between the two evaluators. Sensitivity improved in the evaluation of the whole lesions (mean sensitivity 89.7%) in comparison with the evaluation of EH or non\u2010EH alone (72.7\u201362.6%). Specificity increased when evaluating the EH (54.1%). Positive predictive value (PPV) and likelihood ratio (LR+) of EH resulted 52.3% and 1.4, meaning that in one case out of two with EH is a melanoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lesions with EH are challenging, regardless of dermoscopic experience. The EH is a robust criterion for malignancy, since the evaluation of the whole lesion, through an intralesional comparative approach, increases sensitivity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16604","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:05:09Z","timestamp":1589414709000},"page":"2802-2808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The presence of eccentric hyperpigmentation should raise the suspicion of melanoma"],"prefix":"10.1111","volume":"34","author":[{"given":"S.","family":"Borsari","sequence":"first","affiliation":[{"name":"Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unit\u00e0 Sanitaria Locale \u2010 IRCCS di Reggio Emilia Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Peccerillo","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-879X","authenticated-orcid":false,"given":"R.","family":"Pampena","sequence":"additional","affiliation":[{"name":"Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unit\u00e0 Sanitaria Locale \u2010 IRCCS di Reggio Emilia Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lai","sequence":"additional","affiliation":[{"name":"Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unit\u00e0 Sanitaria Locale \u2010 IRCCS di Reggio Emilia Reggio Emilia Italy"},{"name":"Department of Dermatology University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Spadafora","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5160-8997","authenticated-orcid":false,"given":"E.","family":"Moscarella","sequence":"additional","affiliation":[{"name":"Dermatology Unit Second University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-0964","authenticated-orcid":false,"given":"A.","family":"Lallas","sequence":"additional","affiliation":[{"name":"First Department of Dermatology Aristotle University Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4201-8490","authenticated-orcid":false,"given":"M.A.","family":"Pizzichetta","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Trieste Trieste Italy"},{"name":"Division of Medical Oncology \u2010 Preventive Oncology National Cancer Institute Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Zalaudek","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Trieste Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Del Regno","sequence":"additional","affiliation":[{"name":"Institute of Dermatology Catholic University of Rome and Fondazione Policlinico Universitario A. Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1957-6600","authenticated-orcid":false,"given":"K.","family":"Peris","sequence":"additional","affiliation":[{"name":"Institute of Dermatology Catholic University of Rome and Fondazione Policlinico Universitario A. Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-3896","authenticated-orcid":false,"given":"C.","family":"Longo","sequence":"additional","affiliation":[{"name":"Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unit\u00e0 Sanitaria Locale \u2010 IRCCS di Reggio Emilia Reggio Emilia Italy"},{"name":"Department of Dermatology University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1994.01690080079011"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(02)00679-4"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2003.05343.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.cmr.0000195700.42766.23"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.4.479"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.11.1440"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2010.311"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.137.12.1575"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.10194.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13632"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.06.149"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2007.06.010"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.16604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.16604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.16604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.16604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T19:23:34Z","timestamp":1693423414000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.16604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,5]]},"references-count":12,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/jdv.16604"],"URL":"https:\/\/doi.org\/10.1111\/jdv.16604","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,5]]},"assertion":[{"value":"2020-02-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}