Cutaneous melanocytic tumours encompass a wide range of tumours with benign, intermediate and malignant subtypes. Morphological diagnosis in this field is renowned for its high level of difficulty.
Recent advances in genomics have given insight on the growing complexity in the classification in this field. The 2018 WHO classification introduced morpho-genetic correlations but remains incomplete as new entities are described.
Many immunohistochemical stains and molecular tools are available to support the diagnosis in rare subtypes.
The main curative treatment for of melanocytic tumours is an adapted local surgical resection.
There are many difficulties in assessing the prognostic category in which a case belongs. These lesions can arise in children as early as birth or in skin locations that can have a high esthetic impact.
Second opinion can confirm the necessity of the surgery and guide the clinician for an optimized follow-up. In some instances molecular techniques can identify therapeutic targets which could be potentially helpful for a personalized treatment in malignant cases.