Impact of second histopathological review of melanocytic skin lesions at a melanoma reference center in Brazil

Ital J Dermatol Venerol. 2023 Feb;158(1):49-54. doi: 10.23736/S2784-8671.23.07494-7. Epub 2023 Feb 21.

Abstract

Background: After the biopsy of a suspicious melanocytic lesion, patients depend on the pathologist's precision of specimen evaluation.

Methods: We assessed the agreement between histopathological reports made by general pathologists and reviewed by a dermatopathologist to evaluate the impact on the patient's management.

Results: In 79 cases analyzed, underdiagnosis was observed in 21.6% and overdiagnosis in 17.7%, resulting in changes in the patients' conduct. The assessment of the Clark level, ulceration and histological type showed mild agreement (P<0.001); the Breslow thickness, surgical margin, and staging showed moderate agreement (P<0.001).

Conclusions: A dermatopathologist's review should be incorporated into the routine of reference services for pigmented lesions.

MeSH terms

  • Brazil / epidemiology
  • Humans
  • Melanocytes / pathology
  • Melanoma*
  • Skin Diseases*
  • Skin Neoplasms* / diagnosis