In an article captioned, "Unusual variants of malignant melanoma" that appeared in Modern Pathology, [13] Magro, Crowson, and Mihm addressed what they now call "Equine/animal-type melanoma in humans: malignant melanoma with prominent pigment synthesis." In that section of their piece, the coworkers recalled some of the history remarkable of the "equine/animal-type melanoma in humans" in these lines: "The close association of the tumor cells to the follicular sheath has prompted an alternative appellation for this neoplasm, namely pilar neurocristic hamartoma. The latter is apparently a hamartomatous lesion in which melanoma with prominent melanin synthesis may arise; some cases of animal-type melanoma develop in the setting of a hybrid pattern of blue nevus with a background perifollicular and perieccrine population of well-differentiated pigment-laden cells which seem to give rise to the loci of melanoma . . . One case of our series had a precursor lesion suggestive of a cellular blue nevus, whereas the other cases had areas recapitulating the morphology of common blue nevus,"

It is tedious to conduct a critique yet again of this muddle; a reader is able to do that as well as can we. What now does deserve comment, however, is this suggestion of the coauthors:

Perhaps these tumors [equine/animal-type melanomas in humans] should be considered a form of aggressive dermal melanocytosis with a potential to metastasize."

This suggestion is boggling! "Melanocytosis" is a term generic meaning "a condition of blackening" secondary to the accumulation of pigmented melanocytes. It does not denote melanoma; it denotes nothing with specificity. But the collaborators affirm that equine/animal-type melanoma is a "form aggressive [whatever that means] of melanocytosis" with "potential to metastasize," an unquestionable evidence of malignancy.

In short, a proliferation of melanocytes with potential for metastasis is a melanoma. But to say that would be too simple for Crowson, Magro, and Mihm. In their mode recondite they much prefer "aggressive dermal melanocytosis," which is an apt choice for companion to "pigmented epithelioid melanocytoma" which also seems to be a melanoma, which the coauthors seem to acknowledge obliquely in this sentence: "A recent study of heavily pigmented epithelioid melanocytic neoplasms lumped together under the common term "pigmented epithelioid melanocytoma" showed regional lymph node metastases in 46% of cases in which lymph node biopsies were performed."

Having worked hard and reflected much on the concept of pigmented epithelioid melanocytoma and related "concepts," our interpretation of the events that led to the coining of the term "pigmented epithelioid melanocytoma" is this: in need of some large series of densely pigmented melanocytic lesions diverse, Mihm and Carney joined forces. To the endeavor Mihm brought his "animal-type" melanomas and Carney his "epithelioid blue nevus." Zembowicz, then a trainee in dermatopathology of Mihm, was assigned the task of wrapping "their" pigmented lesions into a unified "concept" derived essentially from the only characteristic the two lesions had in common, i.e., "heavy" pigmentation. It was decided a priori that "heavy pigmentation" was a criterion useful for diagnosing something (or anything) whence the construction of the "entity" to which they gave the designation "pigmented epithelioid melanocytoma," it meaning nothing more than "heavily pigmented melanocytic lesion" although the phrase is intended to denote a benign tumor of pigmented epithelioid melanocytes (although the manner in which the words are strung conveys, literally, that the tumor is epithelioid, not the melanocytes).

This situation is reminiscent of Jadassohn piloting Tièche toward the concept of "blue nevus," the color of which, in the mind of Jadassohn, being the attribute intriguing and consequential. But, unhappily, just as many lesions other than blue nevus can be blue clinically and many "blue nevi"—histologically defined—are not blue clinically—being gray or black—many different lesions, benign and malignant, can also be black or gray or many other colors. Color, in itself, is not of value diagnostically.

In this schema, a concept abstract is affirmed ex cathedra from an authority (e.g., that pigmentation intense histologically or color clinical of a melanocytic lesion has some significance biologically, to wit,,: good prognosis) and then observations empirical are made to fit neatly into the concept (the "paradigm") leading to conclusions aberrant such as stating that benign and malignant lesions are indistinguishable from one another.

A proper method scientific is based not on an affirmation (e.g., that color means something) but on a doubt (e.g., whether color means something). According to this way of thinking, a series of pigmented melanocytic lesions would have to be analyzed using criteria known to be useful for distinguishing between benign and malignant neoplasms of melanocytes, and acknowledging candidly and clearly before the study is done that the nature precise of those unusual deeply pigmented lesions and the meaning of their pigmentation itself is not known. This remains to be done.