The classic dermoscopic method for diagnosing pigmented skin lesions, called pattern analysis, was set forth by Pehamberger et al. in 1987 [J Am Acad Dermatol]. In the following years other similar qualitative approaches have been elaborated by a few experts all over the world, namely, “Strukturanalyse” by Kreusch and Rassner [Hautarzt 1990], “Grading protocol” by Kenet et al. [Arch Dermatol 1993], and “Surface microscopy algorithm” by Menzies et al. [Arch Dermatol 1996].

As proponents of the classic pattern analysis, we have modified this method. In our estimation each diagnostic category within the realm of pigmented skin lesions is characterized by few global patterns and a rather distinctive combination of specific local features. In some instances, however, additional local features might be observed representing helpful diagnostic clues.

A particular aspect of our approach are the so-called confounding features, i.e. dermoscopic criteria that are infrequently present within a given diagnostic category, thus sometimes leading to false diagnoses. The knowledge of these confounding features will help avoid false-positive and, even more important, false-negative results.

(See table "The diagnostic criteria for pattern analysis as thoroughly explained in step 3")


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