Diagnostic discord with melanoma.

The study of the Pathology Panel of the Dutch Melanoma Working Party highlights the great difficulty in achieving uniform diagnostic assessment of melanoma. Their solution is to set up a national reference panel and to focus continuing medical education on identified areas of particular difficulty. This could be appropriate for other countries, although selection of referees and funding may be problematic. It may also be timely to consider whether melanoma terminology can be rationalized to make it more likely to be reported consistently by pathologists whilst still providing sufficient information for proper patient management. Alternatively the reporting of most melanocytic lesions could be confined to pathologists who specialise in this subject, a practice which has evolved for other areas of pathology. This would facilitate the maintenance of standards and uniformity among that smaller group, but it would not avoid the need for a continuing awareness among all pathologists of the diagnostic pitfalls which abound in the area of melanocytic lesions.