Whether a pigmented lesion is biopsied because of irregularity or removed for cosmetic purposes, the tissue should always be submitted for microscopic examination. Neglecting the microscopic examination is an open invitation to a future malpractice action simply because the practitioner is unable to prove what was removed. In addition, benign-appearing nevi may, on rare occasions, have clinically inapparent foci of malignant change; the microscopic examination then becomes a potentially lifesaving action. Be certain someone trained in cutaneous pathology examines the tissue. If a report is hedgy or uncertain, request a reading by several fully trained dermatopathologists. Most skin pathologists will automatically seek a consensus on pigmented lesions that are difficult to assess.
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