7-Point Checklist: Validated dermoscopic algorithm for pigmented lesion triage.
Major Criteria (2 pts)
Minor Criteria (1 pt)
Awaiting Observation
Select the dermoscopic features identified during the lesion examination to calculate the 7-point checklist score.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
When to Use
The Argenziano 7-Point Dermoscopy Checklist is a validated, point-scored algorithm for stratifying the melanoma risk of pigmented skin lesions under dermoscopy (epiluminescence microscopy). It provides a structured, teachable approach to dermoscopic diagnosis suitable for dermatologists and trained general practitioners, and is particularly useful in high-volume pigmented lesion clinics where rapid triage decisions are required.
Primary Indications
Triage of clinically equivocal pigmented melanocytic lesions under dermoscopy
Differentiating melanoma from benign melanocytic nevi, dysplastic nevi, and Spitz nevi
Supporting excision decisions in pigmented lesion clinics when pattern analysis is inconclusive
Training and structured learning for dermatologists new to dermoscopy
When NOT to Use
Non-melanocytic lesions (seborrhoeic keratoses, BCC, haemangiomas) — use specific dermoscopic criteria for each lesion type
Acral lentiginous melanoma on palms/soles — parallel ridge pattern is the key criterion; standard 7-point criteria have lower sensitivity
Amelanotic or hypomelanotic lesions — criteria require pigment; use vascular pattern analysis instead
As a replacement for excision — a score ≥ 3 mandates biopsy; dermoscopy does not substitute histopathology
Without formal dermoscopy training — untrained use of the checklist reduces sensitivity and specificity significantly
Clinical Threshold
A score ≥ 3 is highly suspicious for melanoma and mandates excisional biopsy. Avoid punch or shave biopsy when melanoma is suspected — partial sampling may compromise Breslow depth measurement and staging accuracy.
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Breslow & Clark Microstaging, AJCC Melanoma Staging, BWH SCC Staging or the Melanoma Risk Screening to formulate a comprehensive care plan.
Last Comprehensive Review: 2026