We thank Dr Brodell for his comment pointing out the importance of the history of a changing mole for the diagnosis of melanoma. We do agree with his point of view, that a historical component adds substantial information to the clinical presentation of a mole and helps to distinguish between nevi and melanoma. In fact, we recently published a study that showed that the information of recent changes observed and reported by the patient significantly improves the diagnostic accuracy of the ABCD rule for dermatoscopy.1 In that study we concluded that the ABCD rule should be extended to the ABCDE rule, and we proposed that the letter E should stand for enlargement and other changes using exactly the same terminology as proposed by Dr Brodell to describe the meaning of the letter E in the abbreviation ABCDE.
Binder M, Kittler H. Enlarging Common Melanocytic Nevi and the Diagnosis of Malignant Melanoma. Arch Dermatol. 2001;137(2):227-228. doi: