Section 08 of 12
A structured approach
When you examine a lesion, work through these questions in order:
Step 1 — Does it match a clearly benign pattern?
Seborrhoeic keratosis features? Cherry angioma lacunae? Dermatofibroma central white patch? Regular naevus pattern? If the pattern is unequivocal, reassurance is appropriate.
Step 2 — Are any concerning features present?
Asymmetry? Multiple colours? Atypical network? Blue-white veil? Arborising vessels? If any concerning feature is present, the lesion moves out of the "clearly benign" category.
Step 3 — Do any safety-net rules apply?
Blue-black nodule? Amelanotic but changing? Ugly duckling? History of evolution? If yes, your threshold for further evaluation should be low.
Step 4 — What is the site and context?
Acral skin? Sun-damaged skin? Patient history of prior skin cancer or family history? Immunosuppression? Context modifies interpretation — a lesion in a high-risk context deserves a lower threshold.
This four-step structure previews the TADA algorithm you will learn in Module 7. TADA formalises this thinking into a reproducible, evidence-based screening methodology. For now, practise working through these steps in order — benign pattern first, then concerning features, then safety nets, then context.