Odds ratios of each of the
7 criteria were calculated by multivariate analysis.
7-point score of 2 was
given to the 3 criteria with odds ratios more than 5, and a
score of 1 was given to the 4 criteria with odds ratios less
than 5.
By simple addition of the
individual scores a minimum total score of 3 is required for the
diagnosis of melanoma, whereas a total score of less than 3 is
indicative of a non-melanoma.
7-Point Checklist:
Definition and Histopathologic Correlates of the 7 Melanoma-Specific
Dermoscopic Criteria
Criterion
Definition
Histopathologic
correlates
1. Atypical pigment
network
Black, brown, or gray network
with irregular meshes and thick lines
Irregular and broadened rete
ridges
2. Blue-whitish veil
Irregular, confluent,
gray-blue to whitish-blue diffuse pigmentation
Acanthotic epidermis with focal
hypergranulosis above sheets of
heavily pigmented melanocytes in the
dermis
3. Atypical vascular
pattern
Linear-irregular or dotted
vessels not clearly combined with regression structures
Neovascularization
4. Irregular streaks
Irregular, more or less
confluent, linear structures not clearly combined with
pigment network lines
Confluent junctional nests of
melanocytes
5. Irregular pigmentation
Black, brown, and/or gray
pigmented areas with irregular shape and/or distribution
Hyperpigmentation throughout
the epidermis and/or upper dermis
6. Irregular dots/globules
Black, brown, and/or gray
round to oval, variously sized structures irregularly
distributed within the lesion
Pigment aggregates within
stratum corneum, epidermis, dermo-epidermal junction, or
papillary dermis
7. Regression structures
White areas (white scarlike
areas) and blue areas (gray-blue areas, peppering, multiple
blue-gray dots) may be associated, thus featuring so-called
blue-whitish areas virtually indistinguishable from
blue-whitish veil
Thickned papillary dermis with
fibrosis and/or variable amounts of melanophages
7-Point
Checklist. A minimum total score of 3 is required for the diagnosis
of melanoma
ELM criterion
Odds ratioa
7-point scoreb
Major criteria:
1. Atypical pigment network
5.19
2
2. Blue-whitish veil
11.1
2
3. Atypical vascular pattern
7.42
2
Minor criteria:
4. Irregular streaks
3.01
1
5. Irregular pigmentation
4.90
1
6. Irregular dots/globules
2.93
1
7. Regression structures
3.89
1
a Odds ratios measuring the capacity of each
criterion to increase the probability of melanoma
diagnosis.
b The score for a given criterion is determined on
the basis of the odds ratio: >5 (score = 2), and <5
(score = 1).
Simply add the scores of each
criterion that is present within a pigmented lesion.
