Section 02 of 12
The screening mindset
Before looking at specific features, it is worth establishing the right mental framework.
Primary care dermoscopy is screening, not diagnosis. The goal is not to name every lesion with certainty — it is to sort findings into categories that guide next steps:
- Clearly benign — reassurance, routine monitoring
- Uncertain — closer follow-up, second opinion, or referral
- Concerning — appropriate escalation via local pathways
This three-bucket approach reflects how dermoscopy actually helps in practice. You do not need to be right about what something is — you need to be right about what it isn't.
Your threshold for the "uncertain" and "concerning" buckets should be low, especially early in your dermoscopy learning. It is far better to refer a benign lesion than to reassure a malignant one. Confidence in the "clearly benign" bucket grows with experience.
The patterns in this module help you recognise when a lesion does not belong in the clearly benign bucket — and what to do when that happens.