We appreciate the comments of Dr Heenan regarding the controversy that exists in relation to the histogenesis of NM. His opinion is that NMs should not be viewed any differently from other melanoma subtypes on the grounds that, in his hands, they are never diagnosed at Clark level II and therefore simply represent a more advanced stage of development. While this controversy is acknowledged in our article, his views are at odds with our experience. Since the inception of the Victorian Melanoma Service in 1995 we have identified one 0.35-mm level II NM and 10 NMs less than 1 mm in thickness on histological review.
Chamberlain AJ, Fritschi L, Giles GG, Dowling JP, Kelly JW. Nodular Melanoma Is Not a Distinct Entity—Reply. Arch Dermatol. 2003;139(3):387-388. doi:10.1001/archderm.139.3.387-a