Limitations

Diagnostic Accuracy of Chaos and Clues:⁷
  • Sensitivity 90.6% (BCC: 98.5%, SCC 86.5%, Melanoma 79.3%)
  • Specificity 62.7% (any type)
No method is perfect; use clinical judgment if:
  • Changing lesions (especially elderly), esp. If photographic (macroscopic) or dermoscopic evidence
  • Nodular lesions 
  • Any lesions on the head/neck with a grey colour
  • Lesions palms/soles (acral) with parallel ridge patterns