Abstract

Ongoing controversy exists regarding the terminology used to describe atypical melanocytic nevi. Efforts to standardize nomenclature, including the 1992 NIH consensus conference, have been largely unsuccessful. A 2004 survey of ASDP and AAD members showed “dysplastic nevus” was the most popular terminology, with ten different terms preferred by ?1% of respondents. Since then, significant advances have revealed an increasingly detailed picture of the genetics of melanocytic neoplasms, including strong evidence for the existence of “intermediate” behavior melanocytic neoplasms. We performed an updated survey to assess trends in nomenclature usage and attitudes toward developing new consensus nomenclature for atypical melanocytic nevi. An electronic survey was sent in July 2021 to dermatopathologists (n=846) via email. There were 229 complete responses, for a response rate of 27.1%. The most used/most preferred nomenclature was “dysplastic nevus” (43%/39%, respectively), followed by the NIH terminology “melanocytic nevus with architectural disorder and cytologic atypia” (28%/26%). A total of 14 different terms received ?1% support. Three-tier grading systems were most heavily used/most preferred (79%/63%). Dermatopathologists in New England were most likely to use the NIH terminology, whereas “dysplastic nevus” or ‘other’ were most used elsewhere (p=0.029). Those in academic practice expressed strongest preference for ‘other’ terminology (64%) with little (6%) preference for NIH terminology, compared to 19% overall (OR=0.18, 95% CI=0.068-0.48). The majority (76%) expressed “moderate” or higher enthusiasm for developing consensus nomenclature, with 47% “very” or “extremely” enthusiastic. We found that little has changed with the wide variation in terminology for atypical melanocytic nevi. There continues to be no one dominant terminology in use. However, there is enthusiasm for standardization. A new attempt at updated consensus nomenclature may be fruitful.

Financial Disclosure:
No current or relevant financial relationships exist.