One of the major problems in the field of melanocytic skin tumors is the underdiagnosis of melanoma as a benign melanocytic or non-melanocytic lesion, such as Clark nevus, Reed nevus, or seborrheic keratosis to name but a few examples. Especially colleagues who already have some formal training in dermoscopy are prone to underdiagnose melanomas as specific “benign” entities, thus avoiding surgical excision and subsequent histopathologic examination. 

In the following pages we specifically address this issue by providing examples of false-negative melanomas and try to explain which dermoscopic features actually lead astray to a diagnostic pitfall. This series of examples somehow reflect our learning curve in dealing with dermoscopy of equivocal pigmented skin lesions.