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The dermatoscopic method known as Chaos and Clues was first described by Dr Cliff Rosendahl. It helps the observer to decide if a lesion should be excised.
With certain exceptions, a malignant (or at least, suspicious) pigmented skin lesion can be identified with confidence on dermatoscopy if it has:
Chaos is defined as asymmetry of structure/colour and ≥2 patterns.
The 9 clues to malignancy are:
If two of the three features below are present, consider excision.
Total score >2 points indicates lesion is suspicious.
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