Hu et al1 describe 3 patients in whom cutaneous melanomas were detected after interferon alfa therapy was initiated. The melanomas developed in patients who had already been diagnosed as having metastatic melanoma to lymph nodes. Three things are striking in Hu and colleagues' article. First, the patients did remarkably well, despite the presence of metastatic disease, considering that patients with this degree of tumor burden usually have a bleak prognosis. Second, thin melanomas were found in the patients after the initiation of interferon therapy through the detection of newly inflamed pigmented lesions. Third, metastatic disease does not always mean resistance to therapy.