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Reply to unstable solar lentigo is not a defined separate entity

histopathologists to consider, but without concordance between histopathologists there is a real risk of confusing the field even further, similar to the confusion that still reigns over the term ‘dysplastic naevus’. With no objective and reproducible criteria to establish the dividing line between solar lentigos and unstable solar lentigos, it would be difficult for histopathologists to definitively exclude unstable solar lentigos, resulting in equivocal reports and subsequent uncertainty and anxiety on the part of clinicians as far as choosing the appropriate management. Furthermore, the use of the adjective ‘unstable’ to describe this entity is very unwise, for a number of reasons. The term ‘unstable’ implies that these lesions are likely to undergo a change, and the use of the term therefore implies that the histopathologist somehow is making a prediction for the future behaviour of the lesion or at least making a statement that the lesion is at increased risk of becoming a melanoma in future, and therefore, by the authors’ own advice, should be completely excised. However, even in the unlikely case that other histopathologists could agree on the diagnostic features of this entity, the authors have not given any firm evidence for which lentigines are indeed a precursor of melanoma and which lentigines will remain as normal lentigines. Therefore, were this term to become widely used it would force clinicians to perform numerous unnecessary excisions of what are, in fact, normal benign lentigines; that is, a diagnosis of ‘unstable lentigo’ would force clinicians to practice in a medicolegally defensive manner. Patients would suffer the inconvenience, expense and other adverse consequences of many unnecessary excisions for benign lentigines. In conclusion, it would be unwise to introduce the term ‘unstable lentigo’ to describe a benign solar lentigo with normal melanocytes.