Small-diameter melanoma: toward a conceptual and practical reappraisal

A recent paper by Torres‐Cabala et al.1 published in the JCP reports that about 10% (13/136) of small (3 mm or less in size) dysplastic melanocytic nevi show severe architectural disorder, which, however, is almost never coupled with severe cytologic atypia. It is therefore suggested that, in order to avoid overdiagnosis of melanoma, the significance of architectural changes of small melanocytic lesions must be interpreted with caution; the small size of the lesion hampers the evaluation of some of these criteria (symmetry, confluence of junctional nests and degree of single cell proliferation).