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June 1983

Call Level I (In Situ) Malignant Melanoma What It Is

Author Affiliations

New Mexico Skin Cancer Project 114 Oak St NE Albuquerque, NM 87106

Arch Dermatol. 1983;119(6):452. doi:10.1001/archderm.1983.01650300006005

To the Editor.—  Many cases of level I (in situ) malignant melanoma are described in clinical records by pathologists around the world as "atypical melanocytic hyperplasia" or by some similar term. The reason for this is a humanitarian concern that the patient, once labeled with the diagnosis of "melanoma," might have difficulty obtaining insurance in the future. As noble as this concern may be, the practice it inspires should cease. We should call level I (in situ) malignant melanoma what it is.As Ackerman1 stated, "It is when the lesions are flat and when the atypical melanocytes are wholly confined to the epidermis, that the disease is curable in all cases." The cure rate, therefore, is not influenced by describing level I (in situ) malignant melanoma by any other name. It is time that insurance company medical directors and their underwriting colleagues be urged to change their underwriting policies,