Journal
AMERICAN JOURNAL OF DERMATOPATHOLOGY
Volume 36, Issue 5, Pages 387-391Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/DAD.0b013e3182a3877a
Keywords
melan-A; S100; immunohistochemistry; lentigo maligna; lentigo maligna melanoma; microinvasion
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Background:To assess the usefulness of routine melan-A immunohistochemistry (IHC) for exclusion of microinvasion in lentigo maligna (LM).Methods:One hundred and twenty cases of LM from our archives were reviewed by 2 authors with S100 protein and melan-A IHC using a red chromogen.Results:Melan-A was useful to confirm the diagnosis of LM in early lesions and to differentiate these from chronically sun-damaged skin. The presence of scattered melan-A-positive cells was noted in the dermis in 72 of 120 cases (melanophages in 36 cases, nonspecific cells different to melanophages in 16 cases, and a dual cell population in 20 cases). The significance of these cells was uncertain. Only 3 cases suspicious for microinvasion were identified: 2 on haematoxylin and eosin and 1 on S100.Conclusions:We recommend use of melan-A to confirm the diagnosis in early lesions of LM and in the differential diagnosis from melanocytic hyperplasia in chronically sun-exposed skin. We do not recommend routine use of melan-A to identify or exclude microinvasion. However, it may have a role, in conjunction with S100, in cases with suspicious features for early invasion on haematoxylin and eosin sections.
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