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National Institutes of Health consensus report on precursors to malignant melanoma. A difference in opinion.

THE USE of accurate information in cancer genetics can aid the physician immeasurably in cancer-control efforts. The National Institutes of Health (NIH) consensus report dealing with precursors to malignant melanoma 1 failed to address certain evidence available about the genetics, tumor spectrum, and clinical facets of the natural history of the familial atypical multiple mole melanoma (FAMMM) syndrome. This term is synonymous with the hereditary dysplastic nevus syndrome (DNS) but is older and descriptive of all factors (clinical, genetic, and histological), while DNS is only a histological term. In addition, nevi may be absent, as will be discussed later, but the syndrome with its malignant potential can still be present. Thus, DNS is genetically inappropriate, as it does not describe the clinical spectrum of the FAMMM syndrome. 2 The report implied that the large atypical mole is distinctive of the FAMMM syndrome and is the sole cutaneous marker for this