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Dermoscopic algorithms for skin cancer triage

Natalia Jaimes, MD
Ashfaq A Marghoob, MD
Section Editor
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc


Dermoscopy is a noninvasive, in vivo technique used for the evaluation of skin lesions. It allows for the visualization of subsurface skin structures in the epidermis, dermoepidermal junction, and upper dermis, which are otherwise not visible to the naked eye [1-3].

Numerous clinical trials and meta-analyses of studies performed in experimental and clinical settings have demonstrated that dermoscopy increases the sensitivity for the diagnosis of melanoma compared with naked-eye examination [4-8]. However, in general dermatology and primary care practices the main purpose of dermoscopy in the evaluation of pigmented and nonpigmented skin lesions is to help the clinician decide whether or not to perform a skin biopsy, refer to an expert, reassure the patient, or monitor the lesion over time with sequential digital dermoscopy imaging to determine its biologic nature [4].

Triage refers to the sorting out and classification of patients and lesions to determine priority of need and proper place of treatment [9]. In the setting of skin cancer triage, dermoscopy is an important tool that helps identify lesions for which malignancy needs to be ruled out. In the triage setting, a correct management decision (eg, to biopsy or not) is paramount, whereas making a specific diagnosis is less important. For the purpose of deciding which lesion(s) should be biopsied, several simplified algorithms have been proposed for use in a skin cancer triage setting [10-13].

This topic will review several dermoscopic algorithms for pigmented and nonpigmented lesions (table 1). The principles of dermoscopy and dermoscopic evaluation of skin, mucosal, and nail lesions are discussed separately.

(See "Overview of dermoscopy".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 24, 2017.
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