Instrument-dependent criteria

Important criteria that will be better visualized under polarized dermoscopy (PD) include chrysalis/crystalline structures, blood vessels, and rosettes. When evaluating solitary pink or lightly pigmented lesions, maximizing the yield of dermoscopic assessment is important in light of the relative scarcity of dermoscopic criteria in non-pigmented lesions. Clinicians should be aware of instrument-dependent differences in dermoscopic diagnostic criteria. Using PD versus nonpolarized dermoscopy and applying contact versus non-contact dermoscopy will reveal or highlight different dermoscopic features. Commercially available hybrid dermoscopes enable toggling between polarized and nonpolarized modes, allowing the clinician to appreciate the full range of diagnostic criteria in the lesion. The following are important dermoscopic criteria that are instrument dependent: chrysalis/crystalline structures, also termed “shiny white lines” blood vessels; milia cysts and comedo-like openings; ridges and fissures; surface scales; rosettes/cloverleaf-like structures; and blink sign.