We read with interest and support the comments of Argenziano et al regarding the spectrum of melanoma growth rates, the role for opportunistic screening at consultations undertaken for other reasons, and the potential for sequential digital dermoscopy to further evaluate growth rates, particularly among the slow-growing lesions.
We would, however, draw attention to the limited role of dermoscopy in diagnosing nodular and rapidly growing melanomas because many of these lesions display little pigmentation or, if pigment is present, even color distribution and symmetry. Nevertheless, dermoscopy is useful in ruling out the vascular and pigmentary changes associated with basal cell carcinomas and the vascular features and hyperkeratosis associated with squamous cell carcinomas. Further study of dermoscopic features associated with nodular and rapidly growing melanomas may help with their diagnosis, particularly characteristic vascular changes.
Kelly JW, McArthur GA, Wolfe R, Thompson JF, Liu W. Fast-Growing and Slow-Growing Melanomas—Reply. Arch Dermatol. 2007;143(6):799-816. doi:10.1001/archderm.143.6.803