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dermoscopyDermoscopy is a non-invasive diagnostic technique that uses a magnifier and a polarizing light to examine skin lesions in vivo. This hand-held device allows for visualization of subsurface structures that are otherwise not visible with the naked eye. In the 1980s dermoscopy was first established as useful in the diagnosis of pigmented skin lesions. Over the last three decades, dermoscopy has become wide spread with approximately 60% of dermatologists reporting regular use of dermoscopy in recent national surveys. Dermoscopy decreases the frequency of biopsy for benign lesions, thereby improves patient care.

Many diagnostic algorithms have been established to interpret dermoscopic images of pigmented lesions, including pattern analysis, the ABCD rule, the Menzies method, the 7-point checklist and the CASH algorithm. Our approach to dermoscopy is called ASAP: A Simple and Practical Approach to Dermoscopy.  Instead of utilizing scoring systems, like the previously mentioned algorithms, the ASAP method uses simple patterns to determine whether or not a lesion should be biopsied. The dermoscopist identifies known benign patterns, known malignant patterns and suspicious features in an otherwise benign pattern. Lesions with known benign patterns are not biopsied. Lesions with known malignant patterns, suspicious features or unknown patterns are biopsied. This approach will be described in further detail in the dermoscopy tutorials.