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MMS/MART-1 Immunostaining for Atypical Melanocytes

J Am Acad Dermatol; ePub 2018 Jul 9; Etzkorn, et al

Mohs micrographic surgery (MMS) with MART-1 immunostaining achieves excellent local control of specialty-site atypical intraepidermal melanocytic proliferation (AIMP) and permits definitive removal of subclinical spread prior to reconstruction. This according to a study that sought to ascertain the frequency of diagnostic change to melanoma (upstaging) and the frequency of local recurrence after MMS for AIMP. A secondary outcome was the frequency of subclinical spread (defined as the requirement for >1 stage of MMS to achieve tumor-free margins). Researchers performed a retrospective, cross-sectional study of 223 AIMP (with 92.4% located on the head, neck, hand, foot, or pretibial leg) treated with MMS with MART-1 immunostaining. They found:

  • Upstaging to unequivocal melanoma in situ (MIS) or invasive melanoma was identified in 18.8% (42/223) of all AIMP.
  • The local recurrence rate was 0% (0/223) with a mean follow-up time of 2.7 years (998 days).
  • Subclinical spread was present in 23.8% (53/223) of AIMP.

Etzkorn JR, Jew OS, Shin TM, Sobanko JF, Neal DE, Miller CJ. Mohs micrographic surgery (MMS) with MART-1 immunostaining for atypical intraepidermal melanocytic proliferation (AIMP). [Published online ahead of print July 9, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.06.058.