David E. Elder
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<span>WHO</span> classification of skin tumours: key updates in the fifth edition Open
The 5th edition of the World Health Organization Classification of Tumours (WCT) serves as a foundation for global diagnostic standards in tumour pathology. Similar to other volumes in this series, the Skin Tumours (Skin5) edition follows …
View article: Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, <scp>MPATH</scp> ‐Dx <scp>V2.0</scp> and the <scp>WHO</scp> Skin5
Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, <span>MPATH</span> ‐Dx <span>V2.0</span> and the <span>WHO</span> Skin5 Open
In this Special Issue of the Journal of Cutaneous Pathology in memory of Dr. Martin C. Mihm, Jr, we highlight his many contributions over more than 50 years to the catalog of specific melanocytic tumor terminology. Dr. Mihm was an active p…
Impact of alternative diagnostic labels for melanoma in situ on management choices and psychological outcomes: protocol for an online randomised study Open
Introduction A diagnosis of melanoma in situ presents negligible risk to a person’s lifespan or physical well-being, but existing terminology makes it difficult for patients to distinguish these from higher risk invasive melanomas. This st…
Melanoma Diagnosis in the Mihm Era—And Beyond Open
During the illustrious career of Martin C. Mihm Jr., MD, the diagnosis of melanoma underwent significant changes, to which he made many contributions. In early descriptions, melanomas were fungating tumor masses that were obviously maligna…
View article: Data from Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival
Data from Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival Open
Purpose:Neoadjuvant anti–PD-1 therapy in melanoma may increase tumor-infiltrating lymphocytes (TIL), and more TIL are associated with better treatment response. A major pathologic response (MPR) in melanoma after neoadjuvant anti–PD-1 ther…
View article: Supplementary Data 1 from Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival
Supplementary Data 1 from Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival Open
All supplemental data (Supp Figs S1-S4)
View article: Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival
Tumor-Infiltrating Lymphocytes in Necrotic Tumors after Melanoma Neoadjuvant Anti–PD-1 Therapy Correlate with Pathologic Response and Recurrence-Free Survival Open
Purpose: Neoadjuvant anti–PD-1 therapy in melanoma may increase tumor-infiltrating lymphocytes (TIL), and more TIL are associated with better treatment response. A major pathologic response (MPR) in melanoma after neoadjuvant anti–PD-1 the…
View article: International Skin Imaging Collaboration‐Designated Diagnoses (ISIC‐DX): Consensus terminology for lesion diagnostic labeling
International Skin Imaging Collaboration‐Designated Diagnoses (ISIC‐DX): Consensus terminology for lesion diagnostic labeling Open
Background A common terminology for diagnosis is critically important for clinical communication, education, research and artificial intelligence. Prevailing lexicons are limited in fully representing skin neoplasms. Objectives To achieve …
View article: The Impact of Next-generation Sequencing on Interobserver Agreement and Diagnostic Accuracy of Desmoplastic Melanocytic Neoplasms
The Impact of Next-generation Sequencing on Interobserver Agreement and Diagnostic Accuracy of Desmoplastic Melanocytic Neoplasms Open
Next-generation sequencing (NGS) is increasingly being utilized as an ancillary tool for diagnostically challenging melanocytic neoplasms. It is incumbent upon the pathology community to perform studies assessing the benefits and limitatio…
View article: Pathologist Characteristics Associated With Rendering Higher-Grade Diagnoses for Melanocytic Lesions
Pathologist Characteristics Associated With Rendering Higher-Grade Diagnoses for Melanocytic Lesions Open
Importance The incidence of melanoma diagnoses has been increasing in recent decades, and controlled studies have indicated high histopathologic discordance across the intermediate range of melanocytic lesions. The respective causes for th…
Prognostic Significance of Incipient Ulceration in Primary Cutaneous Melanoma Open
Importance Ulceration represents a key feature in cutaneous melanoma, contributing to staging according to the current American Joint Committee on Cancer (AJCC) system. However, cases with incipient ulceration do not quite fulfill the AJCC…
View article: Revision of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis Classification Schema for Melanocytic Lesions
Revision of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis Classification Schema for Melanocytic Lesions Open
Importance A standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The …
View article: Prognostic modeling of cutaneous melanoma stage I patients using cancer registry data identifies subsets with very‐low melanoma mortality
Prognostic modeling of cutaneous melanoma stage I patients using cancer registry data identifies subsets with very‐low melanoma mortality Open
Background Evidence exists that escalating melanoma incidence is due in part to overdiagnosis, the diagnosis of lesions that will not lead to symptoms or death. The authors aimed to characterize subsets of melanoma patients with very‐low r…
View article: Effect of Prior Diagnoses on Dermatopathologists’ Interpretations of Melanocytic Lesions
Effect of Prior Diagnoses on Dermatopathologists’ Interpretations of Melanocytic Lesions Open
Importance Medical second opinions are common, although little is known about the best processes for obtaining them. This study assesses whether knowledge of a prior physician’s diagnosis influences consulting physicians’ diagnoses. Object…
View article: Reproducibility of the histopathologic diagnosis of melanoma and related melanocytic lesions: Results from a testing study and a reference guide for providers
Reproducibility of the histopathologic diagnosis of melanoma and related melanocytic lesions: Results from a testing study and a reference guide for providers Open
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 …
View article: Dermatopathologist Perceptions of Overdiagnosis of Melanocytic Skin Lesions and Association With Diagnostic Behaviors
Dermatopathologist Perceptions of Overdiagnosis of Melanocytic Skin Lesions and Association With Diagnostic Behaviors Open
In this survey study, about two-thirds of dermatopathologists thought that atypical nevi are overdiagnosed, half thought that melanoma in situ is overdiagnosed, and one-third thought that invasive melanoma is overdiagnosed. No statisticall…
View article: Characterization of multiple diagnostic terms in melanocytic skin lesion pathology reports
Characterization of multiple diagnostic terms in melanocytic skin lesion pathology reports Open
Background Histopathologically ambiguous melanocytic lesions lead some pathologists to list multiple diagnostic considerations in the pathology report. The frequency and circumstance of multiple diagnostic considerations remain poorly char…
More than just acral melanoma: the controversies of defining the disease Open
Acral melanoma (AM) is a malignant cutaneous melanocytic tumour specifically located on the palms, soles, and nail apparatus, which are areas of glabrous (hairless) skin. Acral lentiginous melanoma, a subtype of AM, represents a histopatho…
View article: Melanoma in the blink of an eye: Pathologists’ rapid detection, classification, and localization of skin abnormalities
Melanoma in the blink of an eye: Pathologists’ rapid detection, classification, and localization of skin abnormalities Open
Expert radiologists can quickly extract a basic "gist" understanding of a medical image following less than a second exposure, leading to above-chance diagnostic classification of images. Most of this work has focused on radiology tasks (s…
Association of Second-Opinion Strategies in the Histopathologic Diagnosis of Cutaneous Melanocytic Lesions With Diagnostic Accuracy and Population-Level Costs Open
In this decision-analytic model, selective second-opinion strategies for interpretation of melanocytic skin lesions showed the potential to improve diagnostic accuracy and decrease costs relative to no second opinions or universal second o…
The 2018 World Health Organization Classification of Cutaneous, Mucosal, and Uveal Melanoma: Detailed Analysis of 9 Distinct Subtypes Defined by Their Evolutionary Pathway Open
Context.— There have been major advances in the understanding of melanoma since the last revision of the World Health Organization (WHO) classification in 2006. Objective.— To discuss development of the 9 distinct types of melanoma and dis…