I cannot let Dr Walton's¹ attack on dermoscopy go unanswered. Quite often, my patients with melanoma tell me that they themselves found their lesions and brought them to the attention of their physicians (mostly dermatologists), only to be told that they were nothing to worry about. Only at the patients' insistence were the melanomas excised—most, but not all, of them in a timely fashion.

The true number of melanomas pales in comparison to the number of dysplastic nevi (also known as Clark nevi or atypical nevi). On the one hand, our goal is to never misdiagnose melanoma, while trying to avoid unnecessary surgery. On the other hand, our task is made more difficult because melanoma and dysplastic nevi can have the same clinical appearance (the ABCDs [asymmetry, border irregularity, color variation, and diameter >6 mm]).