Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

Abstract

Background: Evolving dermoscopic terminology motivated us to initiate a new consensus.

Objective: We sought to establish a dictionary of standardized terms.

Methods: We reviewed the medical literature, conducted a survey, and convened a discussion among experts.

Results: Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a descriptive terminology based on 5 basic terms. In a survey among members of the International Society of Dermoscopy (IDS) 23.5% (n = 201) participants preferentially use descriptive terminology, 20.1% (n = 172) use metaphoric terminology, and 484 (56.5%) use both. More participants who had been initially trained by metaphoric terminology prefer using descriptive terminology than vice versa (9.7% vs 2.6%, P < .001). Most new terms that were published since the last consensus conference in 2003 were unknown to the majority of the participants. There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms.

Limitations: A consensus seeks a workable compromise but does not guarantee its implementation.

Conclusion: The new consensus provides a revised framework of standardized terms to enhance the consistent use of dermoscopic terminology.

Keywords: consensus; dermatoscopy; melanoma; nevi; noninvasive diagnosis; nonmelanoma skin cancer; pigmented skin lesions; terminology.

Fig 1

Education and current use of dermoscopic terminology in countries with more than 10 respondents.

Fig 2

List of terms included in the survey and proportions of respondents knowing the term.

Fig 3

Important new patterns and clues published since the last consensus conference A, Structureless red background interrupted by prominent follicular openings (“strawberry pattern”) in a facial actinic keratosis. B, Angulated lines (“polygones”) in flat lentiginous melanoma on nonfacial skin. C, Perpendicular white lines (“shiny white lines” or “shiny white streaks” formerly also known as “chrysalis”) in the right upper part of an invasive melanoma. D, “White circles” in a squamous cell carcinoma (image courtesy of Cliff Rosendahl).