{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:32:32Z","timestamp":1790807552936,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due to progressive ageing of the population, the incidence of facial lentigo maligna (LM) of the face is increasing. Many benign simulators of LM and LMM, known as atypical pigmented facial lesions (aPFLs\u2014pigmented actinic keratosis, solar lentigo, seborrheic keratosis, seborrheic\u2010lichenoid keratosis, atypical nevus) may be found on photodamaged skin. This generates many diagnostic issues and increases the number of biopsies, with a subsequent impact on aesthetic outcome and health insurance costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our aim was to develop a risk\u2010scoring classifier\u2010based algorithm to estimate the probability of an aPFL being malignant. A second aim was to compare its diagnostic accuracy with that of dermoscopists so as to define the advantages of using the model in patient management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A total of 154 dermatologists analysed 1111 aPFLs and their management in a teledermatology setting: They performed pattern analysis, gave an intuitive clinical diagnosis and proposed lesion management options (follow\u2010up\/reflectance confocal microscopy\/biopsy). Each case was composed of a dermoscopic and\/or clinical picture plus metadata (histology, age, sex, location, diameter). The risk\u2010scoring classifier was developed and tested on this dataset and then validated on 86 additional aPFLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>facial Integrated Dermoscopic Score (iDScore)<\/jats:italic>\n                      model consisted of seven dermoscopic variables and three objective parameters (diameter\u2009\u2265\u20098\u2009mm, age\u2009\u2265\u200970\u2009years, male sex); the score ranged from 0 to 16. In the testing set, the\n                      <jats:italic>facial iDScore\u2010<\/jats:italic>\n                      aided diagnosis was more accurate (AUC\u2009=\u20090.79 [IC 95% 0.757\u20130.843]) than the intuitive diagnosis proposed by dermatologists (average of 43.5%). In the management study, the score model reduced the number of benign lesions sent for biopsies by 41.5% and increased the number of LM\/LMM cases sent for reflectance confocal microscopy or biopsy instead of follow\u2010up by 66%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>facial iDScore<\/jats:italic>\n                      can be proposed as a feasible tool for managing patients with aPFLs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.19360","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T15:30:20Z","timestamp":1689780620000},"page":"2301-2310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["A risk\u2010scoring model for the differential diagnosis of lentigo maligna and other atypical pigmented facial lesions of the face: The\n                    <i>facial iDScore<\/i>"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-4310","authenticated-orcid":false,"given":"Linda","family":"Tognetti","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1818-6275","authenticated-orcid":false,"given":"Alessandra","family":"Cartocci","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences University of Siena  Siena Italy"},{"name":"Department of Medical Biotechnologies University of Siena  Siena 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Antonietta","family":"Pizzichetta","sequence":"additional","affiliation":[{"name":"Dermatology Clinic Ospedale di Trieste  Trieste Italy"},{"name":"Department of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO), IRCCS  Aviano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5160-8997","authenticated-orcid":false,"given":"Elvira","family":"Moscarella","sequence":"additional","affiliation":[{"name":"Dermatology Unit University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Longo","sequence":"additional","affiliation":[{"name":"Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unit\u00e0 Sanitaria Locale IRCCS di Reggio Emilia  Reggio Emilia Italy"},{"name":"Department of Dermatology University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7088-9077","authenticated-orcid":false,"given":"Francesca","family":"Farnetani","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-6694","authenticated-orcid":false,"given":"Stefania","family":"Guida","sequence":"additional","affiliation":[{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"},{"name":"Dermatology Clinic IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1326-8535","authenticated-orcid":false,"given":"John","family":"Paoli","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University 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