An atypical nevus is benign and typically more stable, whereas MIS, while also irregular, may show more pronounced changes or asymmetry, and is confirmed as malignant on biopsy.
A CMN is present from birth, a different history than an acquired MIS lesion in an adult.
A simple junctional nevus is small, symmetric, and uniform in color, lacking the larger size and irregularity of an MIS.
A simple solar lentigo is stable and uniform in color, whereas an MIS (especially lentigo maligna type) is characterized by slow but persistent enlargement and color variegation.
This is the most common type of MIS on the head and neck, distinguished by its specific location on chronically sun-damaged skin.
MIS is distinguished from invasive melanoma by being a completely flat patch or macule, with malignant cells confined to the epidermis, lacking any dermal invasion or palpable component.
A pigmented BCC, even when flat, often has subtle clues like a translucent or pearly quality at the border, which is not a feature of MIS.
A flat, pigmented SK (solar lentigo) can mimic MIS, but it often develops a slightly waxy or verrucous texture over time, and dermoscopy can help differentiate.
