A Diagnosis of Dysplastic Naevus has no Clinical Relevance and Unnecessarily Confounds Therapeutic Decision‐Making

ABSTRACT The term ‘dysplastic naevus’ first introduced in 1980, has since engendered considerable debate regarding its ontological legitimacy, the appropriateness of its nomenclature, and its potential prognostic significance. In this review, we undertake a critical examination of the extant literature, including a focus on the past decade. We will present case‐based evidence elucidating how the persisting misdiagnosis of certain melanoma foci as dysplastic naevus, an interpretive approach adopted by many pathologists since 1980, has perpetuated the misconception that dysplastic naevi serve as definitive precursors to melanoma. We will also attempt to explain the persisting popularity of the diagnosis. We assert, based on current knowledge as detailed and explored in this review, that irrespective of whether it exists as a histological entity, and regardless of its persistence in practice, a diagnosis of dysplastic naevus by pathologists has no clinical relevance and that it does harm, by unnecessarily complicating the therapeutic decision‐making role of clinicians.