Never perform laser treatment of skin tumors with clinical "EFG" criteria.

Laser treatment is a common procedure for the treatment of cosmetically troubling skin lesions but has the limitation that histopathologic diagnosis is usually not obtained prior to treatment. Laser treatment of melanomas with benign clinical features may delay or make more difficult the correct diagnosis of such tumors. A helpful tool to identify clinically innocent appearing melanomas is the "EFG" rule, summarizing the common clinical features as "elevated, firm skin lesions showing continuous growth". We report a 42-year-old woman who presented with a recurrent and metastatic melanoma after laser treatment of a tumor which was apparently clinically innocent and highlight the clinical features of such benign-looking melanomas.