Orit Markowitz, MD, is an Assistant Professor of Dermatology at the Icahn School of Medicine at Mount Sinai and is the director of Pigmented Lesions and Skin Cancer in the Department of Dermatology in the Faculty Practice Mount Sinai Doctors.

Orit Markowitz, MD

2025 SDPA Annual Summer Dermatology Conference

 in Washington, DC, Orit Markowitz, MD, spoke about some of the key points highlighted in her session titled ‘Dermoscopy Track: Recognizing Benign Patterns in Dermoscopy: Tools for Clinical Confidence.’

Markowitz, known for her work as an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai and as Director of Pigmented Lesions and Skin Cancer at the Faculty Practice Mount Sinai Doctors’ Department of Dermatology. During this interview with 

, Markowitz was asked about some of the most common benign 

 that clinicians and physician associates (PAs) can misinterpret.

Common Misinterpretations of Benign Dermoscopic Patterns, with Orit Markowitz, MD

“Clinicians, for example, might get very excited when they see something that clinically scares them,” Markowitz explained. “For example, a lot of times, seborrheic keratosis might have some tindling, which is the blue discoloration, and they're elevated and follow all the A, B, C, D, E, clinical criteria. Then you look dermoscopically, and you start worrying. But this is a benign lesion. Then, you really should use some of the category patterns. People will be worried about aggressive skin cancers, and if they see that it's an elevated lesion, then look dermoscopically and it's completely symmetric, even if it's like really dark and really bizarre looking clinically, you don't even need to think about a pattern. That's not an aggressive tumor, that's not a nodular melanoma.”

Markowitz highlighted that her ‘color wheel’ approach, highlighted in her session, allows clinicians and PAs to take a step back and consider what they are truly looking at. She was asked about what were some practical tips that clinicians and PAs can start applying right away to better recognize benign patterns in clinical practice.

“I like my textbook approach, and I'm told that it's very popular among trainees, globally, which is nice,” Markowitz said. “...But there are a lot of online resources, and nowadays it's so easy to take a picture. Way back when, and I don't want to say how many years ago, when I started utilizing dermoscopy in my early practice, I always went back and looked at the images. Whenever I would get a pathology result, especially one that I didn't anticipate and even now today, I'm still going back and asking, ‘What did that look like dermoscopically? What did that look like clinically?’ Build your image library from your own experiences. Obviously, there are many tools today. You can go on, like your dermoscopedia. You'll see my way of diagnosing. You'll see a variety of other ways. Pick the one that makes the most sense for you. In the end, it's going to be tailored to what your own image library has taught you.”

For any additional information on the color wheel approach emphasized by Markowitz, as well as other information on dermoscopy, view her full interview segment above. To learn more about topics like these in dermatology, view our 

The quotes contained in this video summary were edited for clarity.


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In this segment of her SDPA interview, Orit Markowitz, MD, highlights several points about dermoscopy, including common issues with identifying benign lesions.


 is a non-invasive skin examination technique that has changed the assessment of pigmented lesions among dermatologists and physician associates (PAs), but pattern recognition alone may not always suffice for diagnoses.

Orit Markowitz, MD, presented a talk at the 

 in Washington, DC, titled ‘Dermoscopy Track: Recognizing Benign Patterns in Dermoscopy: Tools for Clinical Confidence.’ Markowitz, an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai, spoke about the talk’s main points with 

, highlighting her own unique "color wheel" approach and its use when diagnosing benign conditions.

Strategies for Recognizing Benign Patterns in Dermoscopy, with Orit Markowitz, MD

“The color wheel approach is an approach that just sort of thinks about benign versus malignant,” Markowitz said. “Dermoscopy is a very detailed specialty, and because it's so detailed and literally microscopic, we tend to go into a lot of details before, and sometimes almost get into the weeds, about what's benign and what needs to be biopsied and what doesn't need to be biopsied. So when I was tasked with trying to create a textbook with an approach that I use, it's the polar opposite of getting into the weeds. I like to kind of decide, do I need to cut this human being, though nowadays we have non-invasive imaging, so we don't necessarily need to cut. But do I need to take the extra step in diagnosing, or is this benign?”

Markowitz noted that she utilizes the color wheel to identify patterns to determine whether a lesion is malignant or benign, taking not just what we see dermascopically, but also clinically. She was then asked about how PAs and clinicians can incorporate a color identification strategy into daily practice to improve early detection of malignant lesions across a range of skin tones.

“When we're able to decide whether something is benign or not, we're already 10 steps ahead,” Markowitz explained. “...The other precedent for the color wheel approach was really melanotic melanomas. This is a topic that people are often a little bit anxious about, as they should be, because they're difficult to diagnose lesions, even on dermoscopy, and even on non-invasive devices like confocal. So I tried to boil it down to, what color is it clinically? What color is it dermoscopically? Then get into the weeds of the very subtle details. What this enables us to do is actually catch these lesions very early.”

Markowitz highlighted that, given that certain malignancies, such as a melonotic can progress quite rapidly. Therefore, the ability to diagnose early is essential among healthcare providers if it can be accomplished.

“There are certain just really basic patterns as well, or colors, that enable us to know [something] is malignant,” Markowitz said. “[Even if] it's 2 millimeters in diameter, we can see if it's malignant.”

For any additional information on the color wheel system and Markowitz’s interview, view her full discussion segment posted above. To find out more about related topics, check out our 

The quotes used in this summary were edited for clarity.

Orit Markowitz, MD, highlighted takeaways from her SDPA presentation on the recognition of benign patterns in dermoscopy.

Orit Markowitz, MD

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