To the Editor.—
This study was undertaken to determine the degree of accuracy of dermatologists engaged in office practice in making specific diagnoses of malignant melanoma in both flat and elevated lesions (the term melanoma in this communication is a synonym for malignant melanoma). To that end, slips that accompany biopsy specimens and that provide clinical information about lesions and the patients who bore them were culled specifically for diagnoses of melanoma made consecutively in the dermatopathology unit in the Department of Dermatology, New York (NY) University Medical Center, during a 6-month period between January and June 1990. (Only specimens submitted in formalin, not sections sent in consultation, were included in this study.) Of the 354 melanomas diagnosed by conventional microscopy, 128 (36%) were not recognized as melanoma by the dermatologist who performed the biopsy. (A clinical diagnosis of melanoma was considered to be "correct" if the word "melanoma"