ArticleDermatology practical & conceptual2025
PRAME Immunohistochemical Expression in Recurrent/Traumatized Melanocytic Nevi and the Pitfall of Expression by Reactive Fibroblasts.
Article in Dermatology practical & conceptual, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe recurrent/traumatized melanocytic nevus (RTMN) refers to melanocytic lesions that reappear following incomplete removal or trauma to a previous nevus, often presenting clinically and dermoscopically similar to melanoma, which complicates differential diagnosis. Histologically, RTMN exhibit melanocytic proliferation and scar tissue from prior trauma or excision. PRAME (preferentially expressed antigen in melanoma) immunohistochemistry (IHC) is emerging as a diagnostic tool for distinguishing between nevi, melanoma, and nevus-associated melanomas. However, its role in RTMN has not yet been established.
objectivesThis study aimed to evaluate the expression of PRAME in RTMN, specifically in the melanocytic and fibroblastic components, to explore its potential diagnostic utility.
methodsA series of 22 RTMN cases from the Pathology Unit of the University of Campania Luigi Vanvitelli Hospital were reviewed. PRAME IHC was performed on formalin-fixed, paraffin-embedded tissue, and staining was evaluated in three compartments: junctional melanocytic, intradermal melanocytic, and fibroblastic scar tissue.
resultsPRAME IHC showed no positivity in the junctional or intradermal melanocytic components of any case. However, five out of 22 cases (22.7%) demonstrated PRAME positivity in the fibroblastic component, which was statistically significant (P=0.0169).
conclusionsThis study suggests that PRAME IHC is negative in the melanocytic components of RTMN, distinguishing it from melanoma. However, PRAME positivity in the fibroblastic scar component warrants careful interpretation to avoid diagnostic pitfalls. These findings emphasize the importance of considering the histological context when using PRAME as a diagnostic marker in RTMN.
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