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Diagnostic Algorithm for Differentiating
Melanocytic from Non-Melanocytic Lesions

[Modified according to Kreusch, Stolz, and Menzies]


Criteria
for melanocytic lesion

  • Pigment network - pseudonetwork
    (See exception 1)
  • Aggregated globules
    (not multiple blue-gray globules)
  • Branched streaks
  • Homogeneus blue pigmentation
    (See exception 2)
  • Parallel pattern
    (on palms/soles and mucosal areas)

Criteria
for seborrheic keratosis

  • Multiple milia-like cysts
  • Comedo-like openings
    (irregular crypts)
  • Light-brown fingerprint-like structures
  • Fissures/ridges
    (brain-like appearance)

Criteria
for basal cell carcinoma

  • Absent pigment network
    AND one of
    :
  • Arborizing vessels
  • Leaf-like areas
  • Large blue-gray ovoid nests
  • Multiple blue-gray globules
  • Spoke wheel areas
  • Ulceration (See exception 3)

Criteria
for vascular lesion

  • Red-blue lacunas
  • Red-bluish to red-black
    homogeneus areas

None of the listed criteria



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