An analysis of interobserver recognition of the histopathologic features of dysplastic nevi from a mixed group of nevomelanocytic lesions.
BACKGROUND
The diagnostic criteria for the histopathologic recognition of the dysplastic nevus are defined, but difficult to apply in practice. However, the use of skin biopsy is on the increase to search for this nevus because of a possible role in melanomagenesis.


OBJECTIVE
The aim was to determine the degree of observer reproducibility in the detection of histologic nevomelanocytic dysplasia as measured across multiple observers and to test whether each observer was precise over a wide sample population. A second aim was to gain some measure of the threshold a person has for such lesions.


METHODS
Histologic specimens from 50 coded nevomelanocytic tumors, which included a group of dysplastic nevi, were independently read by five observers in a blinded fashion. At study completion, the same 50 cases were read again by a melanoma reference pathologist and results analyzed by Cohen's kappa to assess agreement and interobserver variation.


RESULTS
Corrected rates of agreement for dysplastic nevi ranged from 0.32 to 0.71.


CONCLUSIONS
Continued study and experience are required for precision and reproducibility in the histologic recognition of dysplastic nevi.
Duray
P H
PH
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.
DerSimonian
R
R
Barnhill
R
R
Stenn
K
K
Ernstoff
M S
MS
Fine
J
J
Kirkwood
J M
JM
D004416:Dysplastic Nevus Syndrome / Q000473:pathology*; D006801:Humans; D009508:Nevus, Pigmented / Q000473:pathology*; D015588:Observer Variation; D010336:Pathology; D012878:Skin Neoplasms / Q000473:pathology*; D013223:Statistics as Topic