• To triage clinically suspicious pigmented skin lesions using dermoscopy.
• Helps differentiate melanoma from benign melanocytic nevi at the bedside.

• Atypical pigment network: Thickened lines, irregular holes.
• Blue-white veil: Irregular, structureless blue pigmentation with an overlying white "ground-glass" haze.
• Atypical vascular pattern: Linear-irregular or dotted vessels not clearly arrayed.

• Irregular streaks: Radial streaming or pseudopods at the periphery.
• Irregular pigmentation: Structureless areas of brown/black/gray not centrally located.
• Irregular dots/globules: Varying sizes and shapes, distributed asymmetrically.
• Regression structures: White scar-like areas and/or blue pepper-like granules.

• A score of ≥ 3 is highly suspicious for melanoma and mandates excision/biopsy.
• Very high sensitivity, but moderate specificity; benign lesions (like dysplastic nevi or Spitz nevi) can occasionally score ≥ 3.

If score ≥ 3, proceed with excisional biopsy (with 1-3mm margins). Avoid punch biopsies or shave biopsies if melanoma is suspected, as this alters Breslow depth staging.