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October 2017

Uniform Nomenclature to Describe Clinical Features of Pigmented Lesions

Author Affiliations
  • 1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 3Editor, JAMA Dermatology
JAMA Dermatol. 2017;153(10):973-975. doi:10.1001/jamadermatol.2017.3028

Uniform terminology to describe features of malignancy facilitates communication among physicians and disciplines, enabling any clinician to reconstruct the lesion or mass in their mind simply based on the description. It is time to revisit the plethora of terms describing the clinical features of pigmented lesions. In the beginning of mammography, reports by radiologists lacked uniform, clear language, which is similar to the array of terms used in dermatology to describe pigmented lesions (Figure). Mammography readings varied between physicians and institutions, ultimately diminishing the quality and delivery of patient care. In response, the American College of Radiology (ACR) developed the Breast Imaging Reporting and Data System (BI-RADS) with the hopes of standardizing mammography language and reporting.4,5 The Reporting and Data System (RADS) framework was pivotal in the management of breast cancer.4 Furthermore, this system has been replicated in the imaging of several organs. Given the maturity of the RADS framework and its proven success, we are proposing a nomenclature system for the visual classification of melanocytic lesions based on the RADS model.

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