Clinical, dermoscopic and histopathologic diagnosis – Author’s Key Messages

Harald Kittler

Medical University of Vienna | MedUni Vienna · Department of Dermatology, MD

1. The melanoma epidemic can in most parts be explained by changing diagnostic concepts and lower thresholds to diagnose melanoma in situ 

2. In a few decades we transcended from an era of significant underdiagnosis to overdiagnosis of melanoma with undesireed consequences that should not be taken lightly 

3. Suggestions that we should stop performing biopsies for small lesions indicates lack of knowledge and lack of trust in current diagnostic techniques 

4. Dermatoscopy, if used appropriately by sufficiently trained clinicians, will reduce and not inflate the number of excisions and biopsies 

5. To fight overdiagnosis we need to change incentives and reimbursement strategies and install a quality control system for clinicians and pathology labs