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September 1992

The Accuracy of Dermatologists in the Diagnosis of Melanoma-Reply

Author Affiliations

Dermatopathology Unit New York University Medical Center 530 First Ave, Suite 7J New York, NY 10016

Arch Dermatol. 1992;128(9):1278. doi:10.1001/archderm.1992.01680190138026

In Reply.—  Dr Berry only thinks that he lets the pathologist know what is on his mind by using the terms "abnormal nevus," "irregularly pigmented nevus," or "nevus with change." They are considered by him to be euphemisms for melanoma, but a competent pathologist could interpret the first example to mean so-called dysplastic nevus; the second, nevus spilus (congenital speckled lentiginous nevus); and the third, rupture of an infundibular cyst beneath a Miescher nevus on a face. In short, Dr Berry is playing games both with pathologists and with patients when, in my judgment, there is no need to do that. Ironically, Dr Berry surely expects his pathologist to issue specific diagnoses of melanocytic neoplasms, but he feels no obligation to reciprocate.For almost 20 years, many colleagues in pathology have engaged in evasions in regard to diagnosis of melanoma in situ similar to those of Dr Berry. That explicit diagnosis has