Peer Reviewed
Feature Article Dermatology

Using dermoscopy to diagnose pigmented skin lesions

Scott W Menzies
Abstract
This article details a two-step method of diagnosing pigmented skin lesions using dermoscopy (surface microscopy).
Key Points
  • All primary care physicians who practise in countries where melanoma causes significant mortality should learn dermoscopy.
  • Step 1 differentiates melanocytic lesions from nonmelanocytic lesions, and step 2 differentiates benign melanocytic lesions from melanoma.
  • To differentiate benign melanocytic lesions from melanoma (step 2), look for negative and positive features; a melanoma will have neither of the two negative features and one or more of the positive features.
  • The diagnostic sensitivity of dermoscopy is not 100%. The clinical history is also important in leading to a final diagnosis.
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