Skin markings to differentiate benign from malignant lesions: A prospective observational study

Rachel Manci, BS; Michael A. Marchetti, MD; Stephen W. Dusza, DrPH; Megan Dauscher, MS, PA-C; Ashfaq A. Marghoob, MD 

Published: August 18, 2021 Journal of the American Academy of Dermatology

To the Editor: Linear interconnecting depressions on the skin surface create fine lines known as “skin markings,” which are more conspicuous when viewed through a linear-polarized lens.1,2 While a cross-polarized lens permits evaluation of subsurface dermoscopic structures, a linear-polarized lens accentuates the superficial skin markings by filtering out all light except what is directly reflected off the skin’s surface.1,2 Previous reports have suggested that a loss of skin markings may indicate cutaneous malignancy,3 but use of this diagnostic criterion in clinical practice is uncommon.

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