In their recent paper on small cell malignant melanoma,¹ Blessing and co-workers report a series of 15 melanocytic lesions that, on the basis of their histology, were considered to constitute a new variant of naevoid melanoma—melanoma resembling naevus.

I am concerned about the lack of metastases in the reported series. Only documentation of metastasis constitutes formal proof that the lesions are diagnosed correctly as melanomas; histological resemblance to some features of melanoma by itself can never provide the necessary conclusive evidence. In addition, I cannot agree with the authors that some of the features of these lesions—such as vascular proliferation, lymphocytic infiltrate, and lentiginous junctional component—constitute supportive evidence of malignancy. Furthermore, the authors point out that in some respects the lesions resembled benign naevi; it is unclear why the resemblance to melanoma would be more relevant than the resemblance to naevus. From the illustrations provided in the paper, …