Table of Contents 2Step Draft

A clinically oriented pathway for dermoscopic evaluation. First look for a specific recognizable diagnosis. If none is confidently recognized, assess whether the lesion is organized or disorganized and evaluate the relevant diagnostic clues.

Step 1 — Is a specific diagnosis recognizable?	Step 2 — If not: organized or disorganized?
Match the lesion with a well-defined diagnostic pattern and confirm that the clinical context is compatible.	Assess symmetry and the distribution of colors and structures, then look for melanoma clues and important mimickers.
Go to Step 1	Go to Step 2

Step 1 — Is a specific diagnosis recognizable?

Melanocytic nevi with recognizable patterns

Benign non-melanocytic diagnoses

Recognizable malignant and premalignant diagnoses

Additional specific diagnoses

Step 2 — If no specific diagnosis is recognized: organized or disorganized?

Organized lesions

An organized lesion shows symmetry and an orderly distribution of colors and structures. Interpret the overall pattern in its clinical context.

Disorganized lesions and melanoma clues

A disorganized lesion shows asymmetry or an irregular distribution of colors and structures. Assess melanoma-specific clues and relevant mimickers in clinical context.

Pigment network and lines

Dots, globules and structureless areas

Blue, white and regression structures

Vascular and additional melanoma clues

Diagnostic synthesis and management

Special locations

The general algorithm must be adapted for anatomic sites with location-specific structures and diagnostic rules.

Face

Palms and soles

Nails

Mucosa and genital skin

Scars, tattoos and altered skin

Hair and scalp — Trichoscopy

Additional clinical fields

Inflammoscopy and infections

Skin of color

Monitoring, imaging and digital dermoscopy

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