Nodular Melanoma Is Not a Distinct Entity—Reply

Patterns of Detection of Superficial Spreading and Nodular-Type Melanoma: A Multicenter Italian Study

“…The currently accepted classification of melanoma is based on the presence (superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma) or absence (nodular melanoma) of a radial growth phase 5 . Recent studies raised concern about the reliability of such classification, even if the separation between superficial spreading melanoma and nodular melanoma seemed more reliable than that among other histotypes; 6 anyway, this is still an open question 15–20 . Up to now, the above‐mentioned classification remains valid and remind us that nodular melanomas manifest clinically in a quite distinct way compared to melanomas that begin with radial growth phase.…”

Nodular Melanoma: Controversies and Considerations for Containment

“…Although it may prove nearly impossible to detect rapidly growing nodular melanoma, invasive from the outset and biologically aggressive nodular melanomas at thicknesses that pose minimal risk to the patient, early detection will be achieved only with greater awareness of this clinically distinct subtype 6 . Certainly, we previously indicated that nodular melanomas may be detected at an early point, 7 albeit rarely. This is the major challenge facing all patients and clinicians who inspect the skin, which is far more important than the controversy that Heenan continues to labor.…”