«Chaos and Clues» algorithm in routine practice of analyzing dermatoscopic image

Abstract

The article describes theoretical bases and practical aspects of the use in clinical practice of the «Chaos and Clues» algorithm of dermatoscopic diagnostics of pigmented skin lesions developed by a group of scientists from different countries of the world. The article provides a detailed description of the application of this algorithm in conditions of real clinical practice. It was emphasized that the use of dermatoscopy as a simple and non­invasive method of research in the practice of a dermatologist allows a more accurate assessment of skin tumors with a careful review of important additional details of their morphology, which in turn increases the accuracy of the diagnosis. For the most part, the dermatoscopy is performed for the purpose of differential diagnosis and visualization of the pigmentary or vascular structures of the epidermis and upper layers of the dermis. Increasingly, dermatoscopy is successfully used to diagnose unpigmented elements, but this article focuses on the diagnostic algorithm for pigmented neoplasms of the skin. The purpose of this publication is to inform specialists about a clear, concise, understandable and consistent algorithm, necessary for the analysis of patterns visible in dermatoscopy. The article proves that the structure of the «Chaos and Clues» algorithm is extremely simple and convenient for implementation in everyday practice. It is noted that the main advantage of this algorithm is the clarity and logic of using terminology to name elements of a dermatoscopic picture, and an original way to use these characteristics for the purpose of establishing a diagnosis. These characteristics are extremely relevant today, when in various sources of information we come across many visual and descriptive terms that, instead of explaining, introduce misunderstandings in the diagnostic process, unreasonably complicate the terminology, which may mislead an insufficiently experienced medical specialist.