We read with interest the editorial by Carli et al1 commenting on our study published in the December 2001 issue of the ARCHIVES.2 Carli et al stated that the very poor diagnostic performance for melanoma observed in our study strongly contrasts with common sense and common experience and suggests that the operative conditions under which the study was carried out were different from the real ones. It has to be emphasized that the melanomas included in our sample lacked specific dermoscopic criteria and were thus very difficult to diagnose, otherwise these melanomas would have been excised at the patient's first visit. All melanomas and nonmelanomas of our sample were drawn from patients with multiple atypical nevi who represent, in our view, the major target population for sequential imaging of melanocytic skin lesions. We are convinced that the high diagnostic difficulty of our sample was the main reason for the poor diagnostic performance, and not the operative conditions.
Kittler H, Binder M. Follow-up of Melanocytic Skin Lesions With Digital Dermoscopy: Risks and Benefits. Arch Dermatol. 2002;138(10):1379. doi:10.1001/archderm.138.10.1378