Interobserver variability in histopathologic diagnosis of melanocytic neoplasms.

Cohort studyJournal of the American Academy of Dermatology· Apr 2026

Interobserver variability in histopathologic diagnosis of melanocytic neoplasms.

Nora A Alexander, Minjun Park, Haewon Shin … David Y Chen

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DermatopathologyCohort studyDiagnosisQ1IF 2.5

Indeterminate-risk melanocytic lesions were reclassified as benign in most reviewed cases

Interobserver variability in histopathologic diagnosis of melanocytic neoplasms.

Nora A Alexander … David Y Chen

Journal of the American Academy of Dermatology · Apr 2026

Background

Precise histopathologic diagnosis of melanocytic neoplasms is required to guide appropriate clinical management; however, significant interobserver variability remains a challenge and may lead to suboptimal management.

Purpose

To quantify interobserver variability in melanocytic lesion diagnosis and identify factors influencing discordance.

Methods

This retrospective cohort study examines 1491 melanocytic lesions with diagnoses rendered by an external institution that were subsequently reviewed in consultation at our institution.

n = 1491 melanocytic lesions

72.1%

Results

72.1%

most downgraded indeterminate lesions were reclassified as benign, not malignant, on review

n = 1491 melanocytic lesions

More results

Overall diagnostic discordance was 33%.

LIMITATIONS: Single-institution, retrospective study design precludes correlation with outcomes and diagnostic accuracy assessment, and referral bias may limit generalizability.

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Conclusion

Significant interobserver variability persists in melanocytic lesion diagnosis, underscoring the need for refined classification criteria and robust biomarkers to improve diagnostic accuracy and optimize patient management.

Interobserver variability in histopathologic diagnosis of melanocytic neoplasms.

Interobserver variability in histopathologic diagnosis of melanocytic neoplasms.

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