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PRAME Expression and Melanoma In Situ Margin Assessment
Thomas N Helm1, Charlene Lam1, Bohdan Zoshchuk2
1Departments of Dermatology, and.
The American Journal of Dermatopathology
|June 22, 2026
Summary
Determining melanoma in situ margins on sun-damaged skin is challenging. PRAME immunohistochemistry aids in identifying subclinical spread but doesn't fully resolve diagnostic difficulties for lentigo maligna melanoma in situ.
Area of Science:
- Dermatopathology
- Oncology
- Immunohistochemistry
Background:
- Melanoma in situ on chronically sun-damaged skin can have subclinical extensions.
- Accurate margin assessment is crucial for effective treatment of lentigo maligna.
- Clinical visualization often underestimates the true extent of melanoma in situ.
Purpose of the Study:
- To highlight the diagnostic challenges in determining margins for melanoma in situ.
- To evaluate the utility of PRAME immunohistochemistry in assessing subclinical spread.
- To present a case study of lentigo maligna-type melanoma in situ with margin difficulties.
Main Methods:
- Utilized immunohistochemistry, specifically PRAME staining.
- Analyzed a case of melanoma in situ of the lentigo maligna type.
- Correlated clinical findings with histopathological assessment.
Main Results:
- PRAME immunohistochemistry provided additional information regarding subclinical spread.
- Despite PRAME use, determining definitive margins remained a diagnostic challenge.
- The case illustrated limitations in current diagnostic tools for complex melanoma in situ cases.
Conclusions:
- Accurate margin delineation for lentigo maligna-type melanoma in situ remains difficult.
- PRAME immunohistochemistry is a valuable adjunct but not a definitive solution.
- Further advancements are needed for precise margin assessment in challenging melanoma in situ cases.
