Comparison of MITF and melan-A immunohistochemistry during mohs surgery for lentigo maligna-Type melanoma in situ and lentigo maligna melanoma

Kevin N. Christensen, Phillip C. Hochwalt, Thomas L. Hocker, Randall K. Roenigk, Jerry D. Brewer, Christian L. Baum, Clark C. Otley, Christopher J. Arpey

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

BACKGROUND Mohs micrographic surgery (MMS) with frozen section immunohistochemistry is a treatment option for malignant melanoma in situ (MMIS) and lentigo maligna melanoma (LMM). Melan-A is a cytoplasmic melanocyte immunostain useful on frozen sections but may lack specificity. Microphthalmia transcription factor (MITF) is a more specific nuclear melanocyte immunostain less frequently used in MMS. OBJECTIVE To quantify melanocyte density in chronic sun-damaged skin (CSDS), negative margin, and tumor from patients undergoing MMS for MMIS and LMM using MITF and melan-A. METHODS Sixteen patients with MMIS or LMM had frozen sections from CSDS, negative margin, and 12 tumor samples, stained with MITF and melan-A. Melanocyte counts were performed. RESULTS Chronic sun-damaged skin mean melanocyte count (MMC) for MITF and melan-A was 9.8 and 13.7, respectively, (p < .001). Negative margin MMC for MITF and melan-A was 8.84 and 14.06, respectively, (p < .001). Tumor MMC for MITF and melan-A was 63.5 and 62.4, respectively. CONCLUSION Although both MITF and melan-A facilitate the identification of tumor during MMS for MMIS and LMM, the apparent melanocyte density on tumor-free CSDS appears higher with melan-A than MITF. Microphthalmia transcription factor provides a crisp outline of melanocyte nuclei and is a useful alternative stain to melan-A for MMS of melanoma.

Original languageEnglish (US)
Pages (from-to)167-175
Number of pages9
JournalDermatologic Surgery
Volume42
Issue number2
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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