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PRAME Expression in Recurrent/Persistent Melanocytic Nevi

Alison H Kucharik1, Helana Ghali2, Doniya Milani1,3

  • 1Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL.

The American Journal of Dermatopathology
|September 3, 2025
PubMed
Abstract

Insights

PRAME immunohistochemistry is useful for diagnosing recurrent melanocytic nevi. This stain helps differentiate benign nevi from melanoma, improving diagnostic confidence and potentially reducing unnecessary procedures.

Area of Science:

  • Dermatopathology
  • Immunohistochemistry
  • Oncology

Background:

  • Recurrent melanocytic nevi can present with atypical features, complicating diagnosis, especially without prior biopsy information.
  • The PReferentially expressed Antigen in MElanoma (PRAME) stain is used for melanoma diagnosis, but its role in recurrent nevi is unclear.

Purpose of the Study:

  • To evaluate the utility of PRAME immunohistochemistry in distinguishing benign recurrent melanocytic nevi from melanoma.
  • To assess PRAME expression consistency between original and recurrent nevi.

Main Methods:

  • Analyzed PRAME expression in paired original and recurrent melanocytic nevi from 22 patients.
  • Evaluated PRAME immunohistochemistry using staining intensity, percentage of positive melanocytes, and a composite score.

Main Results:

  • PRAME expression patterns were consistent between original and recurrent nevi.
  • All analyzed cases, both original and recurrent nevi, showed negative composite scores for PRAME staining.

Conclusions:

  • PRAME immunohistochemistry demonstrates utility in differentiating benign recurrent nevi from melanoma.
  • Consistent negative PRAME composite scores in recurrent nevi enhance diagnostic confidence and may help avoid unnecessary procedures.
Keywords:
PRAMErecurrent nevus

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