Dysplastic naevi in the differential diagnosis of malignant melanoma by epiluminescence microscopy

The utility of two different epiluminescence microscopy rating protocols were tested prospectively and retrospectively on a group of 115 photographically documented naevi. Initially all naevi were classified histologically as dysplastic. While the first score table was set up only to identify dysplastic naevi, the second system lent itself to the differential diagnosis of malignant melanoma. Using this second scoring table 3 lesions were identified as melanomas directly and in 3 further melanomas the suspicion of dysplasia was confirmed. Malignancy was definitely confirmed only by histology. With regard to the surface microscopic differentiation of melanocytic lesions, the term ''dysplasia'' should not be abandoned. If the diagnosis of melanocytic tumours is problematic a double check of the clinical photograph using specific criteria cougled with histological evaluation appears helpful.