Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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A skin pathology report can look intimidating, but it answers two questions: what the mole was
and whether it was fully removed. The key terms to find are the diagnosis
(e.g. benign naevus, dysplastic naevus, or melanoma), the margins (whether clear tissue
surrounds the lesion), and — if melanoma is mentioned — the Breslow thickness. This guide
decodes each term in plain English so you can understand your own report; your clinician will always interpret
it for your specific situation.
How a Pathology Report Is Laid Out
Most reports have three parts: clinical details (what was sent and why), macroscopic
description (the specimen’s size and appearance to the naked eye), and microscopic
description and diagnosis (what the pathologist saw under the microscope). The conclusion you most need
is in that final section.
The Diagnosis Line
Common diagnoses, from reassuring to significant:
- Benign melanocytic naevus — an ordinary, harmless mole (compound, junctional or intradermal describes where the cells sit).
- Dysplastic (atypical) naevus — a benign mole with some irregular features, often graded mild, moderate or severe.
- Melanoma in situ — the earliest, non-invasive stage, confined to the top layer of skin and highly curable.
- Invasive melanoma — melanoma that has grown deeper; this is where the measurements below matter.
For what each of these means for your treatment and follow-up, see what your results mean and the next steps.
Margins — Was It Fully Removed?
“Margins” describes the border of normal tissue around the lesion. Clear (or negative) margins
mean the lesion was removed completely. Involved (or positive) margins mean lesion cells reach
the edge of the sample, so a small amount may remain — often prompting a further excision to be sure. The report
may give margins in millimetres.
Melanoma-Specific Measurements
If melanoma is diagnosed, these figures guide staging and treatment:
- Breslow thickness — how deep the melanoma extends, in millimetres. The single most important prognostic measure; thinner is better.
- Clark level — which skin layers are involved (an older system, still sometimes reported).
- Ulceration — whether the surface skin is broken; its presence affects staging.
- Mitotic rate — how actively the cells are dividing.
These feed into the formal stage, which your specialist explains alongside the
NICE melanoma guidance.
Quick Glossary
- Naevus
- The medical word for a mole.
- Atypia / dysplasia
- Irregular but non-cancerous cell features, usually graded.
- In situ
- Confined to the surface layer; not invasive.
- Excision
- Surgical removal of the lesion.
Histological analysis at London Skin Clinic is £180. Book an assessment to discuss a report.
Common Questions
- What does “clear margins” mean on my report?
- It means the mole was removed completely, with a border of normal tissue all around it and no lesion cells reaching the cut edge. This is the result you want — it indicates nothing was left behind.
- Is a dysplastic naevus cancer?
- No. A dysplastic (atypical) naevus is a benign mole with some irregular features. It is not melanoma, though having several slightly raises overall melanoma risk and is a reason for monitoring. Severe dysplasia is sometimes re-excised to ensure complete removal.
- Why does Breslow thickness matter?
- For a melanoma, Breslow thickness — how deep it has grown in millimetres — is the most important predictor of outcome and guides treatment. Thinner melanomas, especially in situ, have an excellent prognosis, which is exactly why early detection matters so much.
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