Non-Melanocytic Histopathological Clues for Melanoma Diagnosis: A Practical Review of Solar Elastosis, Stromal Regression, and Epidermal Reaction Patterns. Do Old-School Clues Still Matter?

Histopathologic melanoma diagnosis extends beyond melanocytic cytology to encompass non-melanocytic features: solar elastosis patterns, stromal regression, adnexal relationships, epidermal reaction patterns, and the host inflammatory response.

Epidermal hyperplasia over thick melanomas reflects angiogenesis-related changes, while effacement is a practical red flag in spitzoid lesions.

Ancillary tests are most productive when morphology has already framed the differential.