We thank Dr Bystryn for his interest in our recently published work in this journal.1 Dr Bystryn proposes an alternate explanation for the increase in the incidence of thin melanomas. His explanation relies on a mathematical analysis of the differing impacts of increasing incidence and early detection. According to his model, the combined effect of an overall increase in melanomas and simultaneous improvement in early detection of thin lesions could lead to a stable number of thick melanomas (because their proportion decreases) and an increase in the number of thin melanomas (the proportion of which increases). We agree that the increase in incidence of thin melanomas is in part related to better and earlier detection of melanomas. We also agree that early detection is the best treatment of melanoma and remains essential.
Lipsker DM, Hedelin G. An Alternate Explanation for the Increase in the Incidence of Melanoma Being Restricted to Patients With Thin Lesions—Reply. Arch Dermatol. 2000;136(7):936. doi: