Metaphoric and descriptive terminology in dermoscopy: Combine “blink” with “think”

Letter to the Editor

Dear Editor,

Giacomel, Zalaudek and Marghoob analyzed the different approaches of metaphoric and descriptive terminology in dermoscopy based on lessons from the cognitive sciences [1].

In our view, both approaches are used effectively daily and worldwide:

• “Blink” is the first, more metaphoric-based diagnosis at a glance for most of the lesions in our clinical setting (e.g., “arborizing” vessels or “spoke-wheel” pigmentation are the hint for a basal cell carcinoma, “strawberry” pattern for actinic keratosis).

• “Think” is the analytic procedure which starts when “blink” fails in describing a lesion and this mostly descriptive analysis then starts the process for a correct dermoscopic diagnosis.

There is no doubt that for the metaphoric and descriptive based diagnoses, a simplified and clear, effective and universal dermoscopic language should be the basis in any clinical and scientific setting [1]. For the dermoscopy method, in teaching and in daily use, the question is not that either “blink” (more metaphoric) or “think” (more descriptive) is correct, but both methods could be applied effectively and should be complimentary.