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Chapter-18 Dermatoscopy—Chaos and Clues

BOOK TITLE: Color Atlas of Dermoscopy

Author
1. Rosendahl Cliff
2. Tschandl Philipp
ISBN
9789386056306
DOI
10.5005/jp/books/14253_18
Edition
1/e
Publishing Year
2018
Pages
6
Author Affiliations
1. University of Queensland, Australia; Tehran University of Medical Sciences, Tehran, Iran
2. Medical University of Vienna, Vienna, Austria
Chapter keywords
Dermatoscopy, chaos, clues, pattern analysis, melanocytic lesion, nonmelanocytic lesion, basal cell carcinoma, refinement

Abstract

“Chaos and clues” algorithm has been initially tested against the other commonly known algorithms in regard to interobserver agreement and diagnostic accuracy of melanocytic lesions and showed comparable results (unpublished data by the authors). After that, its application for all lesions regardless of melanocytic nature has also been tested in a consecutive series of patients in a geographic area of high ultraviolet exposure. The chaos algorithm is to scan a lesion for asymmetry in color or structure, in short: “chaos.” This step is designed to be intuitive and quick to enable the physician to evaluate many lesions and quickly skip those which are unequivocally benign. Though seeming very straightforward, the exact evaluation of “chaos” needs some explanation and training of the eye. The second step of the algorithm screens the lesion for the presence of at least one of the further described “clues to malignancy”.

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