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Created 2008.
The dermoscopy 3-point checklist for early detection of skin cancer is fairly easy to learn and has a high sensitivity for melanoma. (1) There a high likelihood of malignancy (melanoma or basal cell carcinoma) if a pigmented skin lesion has any two of these criteria. The 3-point checklist has been designed to allow non-experts not to miss detection of melanomas. However, it is not as specific as pattern analysis (described in a later section).
The main aim of the 3-point checklist is to determine whether the lesion being examined should undergo a biopsy. It does not an require accurate diagnosis to be made as the finer features of the lesion are not examined.
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The following lesions demonstrate approximate symmetry of colour and structure. Shape is not considered.
Cherry angioma
Compound naevus
Compound naevus
Cellular naevus
Solar lentigo
Plantar naevus
Benign naevus
Seborrhoeic keratosis
The lesions below demonstrate asymmetry of colour or structure in one or two axes. Not all asymmetrical lesions are malignant.
Melanoma in situ
Melanoma in situ
Invasive melanoma
Basal cell carcinoma
Plantar naevus
Seborrhoeic keratosis
Lentigo simplex
Congenital naevus
The following lesions are considered to have typical pigment network.
Junctional naevus
Ephilis
Benign naevus
Junctional naevus
Ink spot naevus
Plantar naevus
Facial lentigo
Dermatofibroma
The lesions below have atypical pigment network, with irregular holes and thick lines (broadened network). Streaming or pseudopods would also be considered atypical. Not all lesions with atypical network prove to be malignant.
Melanoma
Lentigo maligna
Melanoma in situ
Lentigo maligna
Melanoma
Lentigo maligna
Lentigo maligna
Atypical naevus
Blue-white structures can refer to any type of blue and/or white colour, i.e. combination of blue-white veil and regression structures, as shown in the following pictures. The colour can be subtle. Not all lesions with blue-white structures are malignant.
Melanoma
Basal cell carcinoma
Melanoma
Lentigo maligna
Congenital naevus
Blue naevus
Dysplastic naevus
Dysplastic naevus
Practice dermoscopy, evaluating skin lesions using the 3-point checklist.
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