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September 9, 1998

Clinical Diagnosis of Moles vs Melanoma

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(10):881-882. doi:10.1001/jama.280.10.881

To the Editor.—In their Rational Clinical Examination entitled "Does This Patient Have a Mole or a Melanoma?" Drs Whited and Grichnik1 fail to realize that the basis of their arguments can only be as strong as the most flawed information in their analysis. Their discussion demonstrates that they fully realize the limitations of the clinical examination, but they fail to acknowledge that the "gold standard" of their study, microscopic examination of the biopsy specimen, has similar limitations. Without the certainty of a true gold standard of biological behavior, all their inferences are suspect.