Pattern analysis

From dermoscopedia

(6 votes)
Description This chapter describes the pattern analysis in dermoscopy
Author(s) Florentia Dimitriou · Harald Kittler
Responsible author Harald Kittler→ send e-mail
Status unknown
Status update October 4, 2019
Status by Ralph P. Braun

This chapter describes the pattern analysis in dermoscopy

It has the following subchapters:

Structures used in pattern analysis
Colors used in pattern analysis
Chaos and clues


  • “Simplified” algorithms such as the ABCD rule, the 7-point checklist, the CASH algorithm, or Menzies' method were developed as uncomplicated and easily assimilated guidelines for daily use. These algorithms are easy to learn but, with the exception of Menzies' method, not easy to apply.
  • Menzies' method is the only scoring system that follows an initial screening based on an overall assessment of pattern and color to determine whether a detailed investigation is worthwhile.
  • The sequence of assessment, first pattern, then color, and finally clues, concurs exactly with the approach of pattern analysis. Menzies' method is a highly simplified version of the algorithms of pattern analysis, but limited to melanocytic lesions.
  • Simple and easily learned rules of thumb based on pattern analysis can be formulated, that fulfill the demand for a rapid and uncomplicated algorithm, but without this restriction to melanocytic lesions (chaos and clues)
  • The basics of pattern analysis are easy to learn, but its application is sometimes complex and needs experience.

Full pattern analysis

  • Pigmented skin lesions can be described very clearly and reliably with the aid of the patterns, colors and clues.
  • Pattern analysis is a structured description in the form of an algorithm with fixed and reproducible rules.

The algorithm always follows this formula:

Pattern + Color + Clues = Diagnosis

  • Based on patterns, colors and clues, the number of potential diagnoses is minimized.
  • In cases in which it is not possible to dispel all doubts in respect of the diagnosis, the degree of doubt and the type of possible diagnoses will be decisive factors to determine whether a histopathological investigation should be performed.


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