Benign and suspicious pink tumors : According to the high sensitivity model of the Menzies score, 129 (12.9%) lesions were considered as non‐suspicious (of which 16 were false negative) and 871 (87.1%) as suspicious (of which 212 were false positive), with 97.6% sensitivity, 34.8% specificity. According to the high specificity model, 370 (37%) lesions were evaluated as non‐suspicious (of which 105 were false negative) and 630 (63%) as suspicious (of which 60 were false positive), with 84.4% sensitivity, 81.5% specificity. Concerning the prevalent criterion method, 316 (31.6%) lesions were evaluated as non‐suspicious (of which 46 were false negative) and 684 (68.4) as suspicious (of which 55 were false positive), with 93.2% sensitivity and 83.1% specificity.

The prevalent dermoscopic criterion to distinguish between benign and suspicious pink tumors
Teresa Russo  Riccardo Pampena  Vincenzo Piccolo  Roberto Alfano  Chryssoula Papageorgiou  Zoe Apalla  Caterina Longo  Aimilios Lallas  Giuseppe Argenziano
First published: 24 May 2019 https://doi.org/10.1111/jdv.15707
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jdv.15707
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Abstract
Background
Pink skin tumors are difficult to differentiate, clinically and dermoscopically. In previous studies, mainly focused on pigmented lesions, pattern analysis provided the best sensitivity and specificity values, as compared to other algorithms. These findings suggest that the global dermoscopic appearance, based on the evaluation of prevalent features, could represent a valuable and practical approach even when dealing with pink lesions.

Objective
In this study we aimed to evaluate the diagnostic accuracy of a new dermoscopic approach for pink tumors based on the prevalent criterion, as compared to a standard diagnostic method (Menzies algorithm).

Methods
The databases of two referral centers were retrospectively evaluated to retrieve dermoscopic images of amelanotic/hypomelanotic skin lesions. Two experts in dermoscopy, blinded for the final diagnosis and for clinical and demographic information, evaluated separately dermoscopic pictures of 1000 lesions according to the Menzies score and to the prevalent criterion method.

Results
According to the high sensitivity model of the Menzies score, 129 (12.9%) lesions were considered as non‐suspicious (of which 16 were false negative) and 871 (87.1%) as suspicious (of which 212 were false positive), with 97.6% sensitivity, 34.8% specificity. According to the high specificity model, 370 (37%) lesions were evaluated as non‐suspicious (of which 105 were false negative) and 630 (63%) as suspicious (of which 60 were false positive), with 84.4% sensitivity, 81.5% specificity.

Concerning the prevalent criterion method, 316 (31.6%) lesions were evaluated as non‐suspicious (of which 46 were false negative) and 684 (68.4) as suspicious (of which 55 were false positive), with 93.2% sensitivity and 83.1% specificity.

Conclusions
This study demonstrated that focusing on the prevalent dermoscopic features could allow to detect malignant pink tumors with similar sensitivity but higher specificity than using the conventional Menzies scoring system.

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