Reproducibility of the Histopathologic Diagnosis of Melanoma and Related Melanocytic Lesions: Results from a Testing Study and a Reference Guide for Providers

To the Editor: The alarming increase in melanoma incidence demands the evaluation of biases in screening and histologic diagnosis.1 Absent disease outcome data, no gold standard exists for the accuracy of histopathology.2 We thus examined intraobserver reproducibility among board-certified or fellowship-trained dermatopathologists, the study design we believed a priori would capture the highest experimental reproducibility rates for melanocytic lesion diagnosis. We focused on the conceptual “common” pathway of melanomagenesis, namely nevus, dysplastic nevus, melanoma in situ (MIS), and invasive melanoma, reflecting low cumulative solar damage and representing the most frequently biopsied (∼80%) melanocytic lesions.