Clinicopathologic Features of PRAME-Positive Common Melanocytic Nevi: A Case-Control Study.

Case-controlThe American Journal of dermatopathology· May 2025

Clinicopathologic Features of PRAME-Positive Common Melanocytic Nevi: A Case-Control Study.

Ronan J Knittel, Nathan T Harvey, Nima Mesbah Ardakani … Benjamin A Wood

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PathologyCase-controlDiagnosisQ3IF 0.6

Pathologists rated PRAME-positive nevi as severely atypical far more often, unmasked

Clinicopathologic Features of PRAME-Positive Common Melanocytic Nevi: A Case-Control Study.

Ronan J Knittel … Benjamin A Wood

The American Journal of dermatopathology · May 2025 · Q3 in Pathology

Methods

We reviewed all pathology reports on common melanocytic nevi seen in routine practice for a 1-month period and found that 7.1% of nevi stained with PRAME were considered positive by the original reporting pathologist.

Results

pathologists called these nevi severely atypical far more often once they knew PRAME was positive

Original diagnosis (PR

54%

Masked review diagnosi

7%

More results

Preferentially Expressed Antigen in Melanoma (PRAME) immunohistochemistry has been found to be relatively sensitive and specific for the diagnosis of melanoma, although the detection of PRAME positivity in some melanocytic nevi is a significant limitation.

More results

A total of 41 PRAME-positive nevi (representing 4.7% of nevi) and a control group of 43 PRAME-negative nevi collected during the same period were identified.

We found a statistically significant association between the presence of solar elastosis and lentiginous growth pattern, and PRAME status ( P < 0.01).

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Conclusion

This finding provides evidence of a "PRAME bias" in the interpretation of melanocytic lesions with no or mild atypia, whereby such lesions are classified as severely atypical when PRAME is positive, likely with the intention of prompting re-excision.

Clinicopathologic Features of PRAME-Positive Common Melanocytic Nevi: A Case-Control Study.

Clinicopathologic Features of PRAME-Positive Common Melanocytic Nevi: A Case-Control Study.

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