p16 Expression differentiates between desmoplastic Spitz nevus and desmoplastic melanoma

Background:  Loss of p16 in melanomas reflects worse outcomes for patients. It is associated with depth of invasion, ulceration, vascular invasion, lymph node metastases, metastases, recurrence of melanoma and decreased 5‐year survival. Desmoplastic melanoma is an insidious malignant melanoma subtyp...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cutaneous pathology 2009-07, Vol.36 (7), p.753-759
Main Authors: Hilliard, Nicholaus J., Krahl, Dieter, Sellheyer, Klaus
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cell Proliferation
Cyclin-Dependent Kinase Inhibitor Proteins - biosynthesis
Dermatology
Diagnosis, Differential
Female
Gene Expression Regulation, Neoplastic
Humans
Ki-67 Antigen - biosynthesis
Lymphatic Metastasis
Male
Medical sciences
Melanoma - diagnosis
Melanoma - metabolism
Melanoma - pathology
Middle Aged
Nevus, Epithelioid and Spindle Cell - diagnosis
Nevus, Epithelioid and Spindle Cell - metabolism
Nevus, Epithelioid and Spindle Cell - pathology
Tumors of the skin and soft tissue. Premalignant lesions
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background:  Loss of p16 in melanomas reflects worse outcomes for patients. It is associated with depth of invasion, ulceration, vascular invasion, lymph node metastases, metastases, recurrence of melanoma and decreased 5‐year survival. Desmoplastic melanoma is an insidious malignant melanoma subtype that commonly occurs on sun‐damaged skin of the head and neck area in elderly patients. The diagnostic conundrum occurs with confusion of desmoplastic melanoma with scars, hyalinizing blue nevi, desmoplastic Spitz nevi and diffuse neurofibromas. Methods:  The present study uses immunohistochemistry with a p16 antibody to differentiate desmoplastic Spitz nevi (n = 15 cases) from desmoplastic melanomas (n = 11). To date, no other studies have been published defining the expression pattern of p16 in desmoplastic melanoma. Results:  81.8% of desmoplastic melanomas were negative for p16 and 18.2% were only weakly stained. In contrast, all desmoplastic Spitz nevi were moderately to strongly positive for p16. Conclusions:  The staining pattern for p16 in desmoplastic melanomas and Spitz nevi in conjunction with the histopathologic features, S100 staining, Ki67 proliferation index and clinical scenario may aid in the difficult differential diagnosis between these two entities. Further confirmatory studies are indicated.
ISSN:0303-6987
1600-0560
DOI:10.1111/j.1600-0560.2008.01154.x