No. Reversibility observed in a study is not a diagnosis of a particular spot. A mole can change in appearance for different reasons, and a photograph or forum description cannot determine which explanation applies. The question deserves assessment rather than an automatic assumption that it is temporary pigmentation.
A small clinical and dermoscopic study followed 15 EPP patients and examined 103 acquired melanocytic nevi during afamelanotide treatment. The investigators observed changes that later returned toward baseline and did not observe dermoscopic features suggesting malignant transformation in that sample. This is useful descriptive evidence, but its scale must remain visible.
The denominator is especially important. One hundred and three lesions are not 103 independent patients with unrelated backgrounds. Multiple lesions belonged to the same people, sharing exposures and clinical characteristics. Counting lesions as if they were separate people would exaggerate how broadly the findings can be generalized.
Nor does “not observed” mean “impossible.” A small study can describe relatively common visible changes while having limited ability to detect rare outcomes. It cannot establish a person's lifetime risk or assure that a lesion outside the study has the same explanation.
The study setting also matters. The participants had EPP and received medically supervised afamelanotide. A report involving an uncertain research product, several other exposures and deliberate UV tanning is not the same setting. Similar pigment changes do not erase those differences.
For a person noticing a new or evolving lesion, the useful information for a clinician includes when it changed, prior photographs if available, and relevant exposures. Those details can assist assessment but do not replace it. Waiting for a presumed fade is not a way to establish benignity.
The balanced conclusion avoids both extremes: the study does not show that every change is malignant, and it does not prove that every change is harmless. It supports careful observation within clinical care. A reassuring small series cannot establish a blanket safety claim.