THE GOAL of early detection of cutaneous melanoma (CM) is to diagnose tumors in a premetastatic stage of development. This strategy is already having a significant impact.1- 5 In 70% of CM cases, tumors are discovered by patients (53%) and family members (17%).6 Unfortunately, early warning signs of CM are frequently not heeded, resulting in delay in diagnosis and treatment. Often, this delay relates to denial or ignorance about the serious consequences of a new or changing mole when patients are aware of their tumors, or lack of awareness because of tumor location and/or failure to practice self-examination.5 Moreover, many physicians are not sufficiently aware of the features of early CM to be suspicious about a mole that is reported to be new or changing. Early detection efforts need to be directed to the lay public and general medical community alike, and any information that is relevant to early detection efforts would be welcome. The study by Kittler et al7 reported in this issue of the ARCHIVES begins a meaningful foray into the natural history of common acquired nevomelanocytic (NM) nevi in adults and children, providing a foundation for further studies of the predictive value of an enlarging mole in the diagnosis of early CM, the predictive value of surface microscopic features of the pigmented spindle cell (PSC) nevus, and the pathobiological characteristics of melanocytic tumors in general.
Arthur R. Rhodes. Common Acquired Nevomelanocytic Nevi and the Fourth Dimension. Arch Dermatol. 2000;136(3):400–405. doi:10.1001/archderm.136.3.400