Pattern analysis

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 Author(s): Florentia Dimitriou, Harald Kittler, Ludovica Toffoli

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Description	This chapter describes the pattern analysis in dermoscopy
Author(s)	Florentia Dimitriou · Harald Kittler · Ludovica Toffoli
Responsible author	Ludovica Toffoli → 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

Dermoscopy, Pattern analysis Pattern analysis – cite! Pattern analysis (message) Pattern analysis – participate!

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Introduction

• Pattern analysis is used to differentiate benign lesions from malignant neoplasms, it permits the immediate assessment of the diagnostic value of the different dermoscopic characteristics of the lesion. The first step is to decide whether the lesion is melanocytic or nonmelanocytic, the second step is the differentiation of benign melanocytic lesions from melanomas.

• Revised pattern analysis is a stepwise algorithmic method (described by Kittler et al.) that uses a limited number of simple defined geometric terms and provides a single step process of analysis.

• “Simplified” algorithms such as the ABCD rule, the 7-point checklist, the CASH algorithm, or Menzies' method were developed to facilitate the use of dermoscopy in daily practice.

References

1. An Atlas of Dermoscopy, Second Edition. Marghoob A. et al. CRC Press; 2012.
2. Altamura, D., Menzies, S.W., Argenziano, G., et al., 2010, Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis. J Am Acad Dermatol, 62, 67–75.
3. Argenziano, G., Soyer, H., Chimenti, S., et al., 2003, Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol, 48, 679–93.
4. Binder, M., Kittler, H., Steiner, A., et al., 1999, Revaluation of the ABCD rule for epiluminescence microscopy. J Am Acad Dermatol, 40(2 Pt 1), 171–6.
5. Binder, M., Schwarz, M., Winkler, A., et al., 1995, Epiluminescence microscopy. A useful tool for the diagnosis of pigmented skin lesions for formally trained dermatologists. Arch Dermatol, 131, 286–91.
6. Braun, R.P., Gaide, O., Oliviero, M., et al., 2007, The significance of multiple blue-grey dots (granularity) for the dermoscopic diagnosis of melanoma. Br J Dermatol, 157, 907–13.
7. Braun, R. P., Rabinovitz, H. S., Oliviero, M., et al., 2002, Pattern analysis: a two-step procedure for the dermoscopic diagnosis of melanoma. Clin Dermatol, 20(3), 236–239.
8. Cameron, A., Rosendahl, C., Tschandl, P., Riedl, E. & Kittler, H., 2010, Dermatos- copy of pigmented Bowen’s disease. J Am Acad Dermatol, 62, 597–604.
9. Chamberlain, A.J., Fritschi, L. & Kelly, J.W., 2003, Nodular melanoma: patients’ perceptions of presenting features and implications for earlier detection. J Am Acad Dermatol, 48, 694–701.
10. Kittler, H., 2007, Dermatoscopy: introduction of a new algorithmic method based on pattern analysis for diagnosis of pigmented skin lesions. Dermatopathol Pract Conc, 13, 1.
11. Kittler, H., Riedl, E., Rosendahl, C. & Cameron, A., 2010, Dermatoscopy of unpigmented lesions of the skin: a new classification of vessel morphology based on pattern analysis. Dermatopathol Pract Conc, 14, 3.
12. Menzies, S.W., Crotty, K.A. & McCarthy, W.H., 1995, The morphologic criteria of the pseudopod in surface microscopy. Arch Dermatol, 131, 436–40.
13. Pehamberger, H., Steiner, A. & Wolff, K., 1987, In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. J Am Acad Dermatol, 17, 571–83.