Adherence to Teledermatology Recommendations by Primary Health Care Professionals

ever, melanoma-specific dermoscopic criteria were present in 6 lesions. This finding highlights the challenge in differentiating CM from melanomas and underscores the importance of interpreting melanoma-specific structures in the context of criteria for melanocytic lesions when using the 2-step algorithm.5 Dermoscopy users must also be familiar with the advantages and limitations of polarized and nonpolarized dermoscopy to maximize diagnostic accuracy because superficial details (eg, comedolike openings) may be poorly visualized or absent with polarized dermoscopy (Figure 2B and C). Surprisingly, few lesions in our series were heavily pigmented, which is contrary to the common textbook description of CM.1 In summary, we found that CMs present a diagnostic challenge. The use of dermoscopy, particularly the 2-step algorithm and pattern analysis, may help to identify these uncommon tumors as benign. Nonetheless, physicians should remain cognizant that melanomas and other cutaneous malignant neoplasms can present with SK-like features or directly in association with SKs. To maintain a high sensitivity for melanoma detection, all skin lesions that cannot be classified as clearly benign should undergo biopsy.