We read with great interest the article by Gómez-Martínez et al.1 published in Actas Dermo-Sifiliográficas, in which the authors provide a detailed review of the applications of Wood's lamp (WL) in dermatology. WL is an inexpensive, accessible, and easy-to-learn tool; however, it remains underused among dermatologists. In recent years, data have begun to emerge suggesting that its usefulness could extend significantly to the diagnosis of pigmented lesions, particularly melanoma.

In this regard, Pietkiewicz et al.2 recently published a multicenter study in the Journal of the American Academy of Dermatology in which they observed that the “ochre fluorescence” seen in melanoma had high diagnostic specificity (97%) and occurred more frequently in invasive melanomas, where it was associated with greater Breslow thickness. Although sensitivity is limited, its potential value lies in its use as an additional marker in equivocal lesions, particularly when conventional dermoscopy is inconclusive.

Along the same lines, Grossman et al.3 validated a cutaneous fluorescence imaging system targeting integrin αvβ3 for the detection of melanoma and high-grade dysplastic nevi. In a prospective trial of 240 pigmented lesions, this system demonstrated a sensitivity rate of 89% and a specificity rate of 94% – substantially higher than those of conventional dermoscopy (53% and 61%, respectively) – for distinguishing high-risk from low-risk lesions.

With reference to the article by Gómez-Martínez et al., one of the most interesting considerations is perhaps the reminder that innovation and simplicity are not opposing concepts. WL is an example of how accessible, low-cost techniques can continue to generate knowledge and new clinical applications many years after their introduction.

Nevertheless, it is also important to maintain a cautious perspective. The available evidence regarding pigmented lesions remains preliminary and heterogeneous, with studies consisting predominantly of retrospective analyses and limited case series. Before these findings can be incorporated into established diagnostic algorithms, prospective studies and greater standardization of the observed fluorescence patterns will be required.