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A quantitative comparison between SOX10 and MART‐1 immunostaining to detect melanocytic hyperplasia in chronically sun‐damaged skin
Author(s) -
Muzumdar Sonal,
Argraves Melissa,
Kristjansson Arni,
Ferenczi Katalin,
Dadras Soheil S.
Publication year - 2018
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13115
Subject(s) - actinic keratosis , medicine , dermatology , pathology , nevus , immunostaining , population , seborrheic keratosis , melanocytic nevus , melanoma , immunohistochemistry , cancer research , environmental health , basal cell
Histologic differentiation of melanoma in situ (MIS) from solar keratosis on chronically sun‐damaged skin is challenging. The first‐line immunostain is usually MART‐1/Melan‐A, which can exaggerate the epidermal melanocytes, causing a diagnostic pitfall for MIS. By comparing MART‐1 and SOX10 immunostaining, we scored the percentage of epidermal melanocytes per 2‐mm diameter fields in pigmented actinic keratosis ( n = 16), lichenoid keratosis ( n = 7), junctional melanocytic nevus ( n = 6), keratosis with atypical melanocytic proliferation ( n = 17) and MIS ( n = 10). These cases represented an older population (68 years median age) and the head and neck (50%) was the most common anatomic site. MART‐1 score was significantly higher than SOX10 ( P value <.05) in solar keratoses, but showed no difference in detecting melanocytic proliferations, demonstrating their equal detection rate of melanocytes. The sensitivity of both MART‐1 and SOX10 was 100%, while their specificities were 17% and 96%, respectively. These results show that SOX10 is more specific than MART‐1 in distinguishing epidermal melanocytes on sun‐damaged skin by avoiding overdiagnosis of melanoma.