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Original Article   

International Angiology 2022 Jul 13

DOI: 10.23736/S0392-9590.22.04909-4


lingua: Inglese

The impact of dermatoscopy on the pre-treatment assessment of lower limbs telangiectasias: a prospective study

Camila K. da SILVA 1, 2, Roberto A. CAFFARO 1, Valter CASTELLI JÚNIOR 1, Walkyria H. BERNARDI 1, Rodrigo KIKUCHI 1, Rebeca H. SANTOS 1, 2, Flávia M. OLIVEIRA 2, Samantha NEVES 1, 3, Camilla M. RIBEIRO 3, Eduardo RAMACCIOTTI 2, 3, 4

1 Vascular Surgery, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, SP, Brazil; 2 Vascular Surgery, Hospital e Maternidade Christóvão da Gama, Santo André, SP, Brazil; 3 Science Valley Research Institute, São Paulo, SP, Brazil; 4 Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA


BACKGROUND: Telangiectasias treatment can lead to skin hyperpigmentation, and pretreatment evaluation with dermoscopy was never performed. This study aimed to evaluate the applicability of dermatoscopy before telangiectasias treatment.
METHODS: A prospective study evaluating patients of both sexes (18 to 60 years old), with telangiectasias (Venous disease C2-C3 CEAP) of the lower limbs treated at outpatient clinics. Subjects who had never undergone previous interventional treatment for CVI and Fitzpatrick classification up to phototype III, were included. Patients were submitted to both naked and dermoscopy evaluations of their skin and blindly evaluated by three vascular surgeons and an experienced dermatologist. Agreement by naked eye versus dermoscopy and among examiners was performed using Kappa correlation. Agreement by naked eye among patients and the examiners consensus was performed.
RESULTS: There was a more significant agreement between the most experienced examiners, in the naked eye assessment. With the dermatoscopic device, the highest agreement was maintained among the more experienced examiners, with a predominance of choice of the purple pigment in 29 of the 38 limbs, which represents a simple agreement of 76.3% (95%CI 62.8-89.8%) with a Kappa concordance index of 0.178. There was an agreement between the patient and the consensus of the naked eye examiners in 41.2% (95%CI 24.7-57.7%).
CONCLUSIONS: The dermatoscopy was not decisive for diagnosing skin pigmentation in areas of telangiectasia that had never been treated. The diagnostic accuracy was directly related to the clinical experience of the examiner. Dermatoscopy did not help in aligning expectations with treatment between physicians and patients.

KEY WORDS: Telangiectasias; Dermoscopy; Skin stains; Sclerotherapy

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