To the Editor: I read with interest the article by Weissinger et al1 ‘A diagnostic algorithm to distinguish desmoplastic from spindle cell melanoma’ published in the September 2013 issue. They propose MelanA as a first and, if positive, exclusionary step in their algorithm. This appears to be based on their cluster analysis of 38 cases (16 spindle cell, 18 desmoplastic, 4 mixed). All 4 of their mixed and all 18 of their desmoplastic melanomas were negative for MelanA. Their meta-review (Supplementary Table 9) is a summary of published immunoprofiles comparing spindle cell to desmoplastic melanoma. It is based on much larger number of cases and suggests that MelanA is not quite that specific and that HMB-45 may actually be of superior discriminatory value than MelanA.

A comment on the difference between their cluster analysis and meta-review of published literature in this regard would be appreciated.