Molecular Characterization of Sclerosing Nevi With Pseudomelanomatous Features.
Sclerosing nevi with pseudomelanomatous features lack the co-occurring genomic alterations seen in BRAF-mutated melanomas.
Molecular Characterization of Sclerosing Nevi With Pseudomelanomatous Features.
Sclerosing nevi with pseudomelanomatous features (sclerosing nevi with pseudomelanomatous features) are rare melanocytic lesions characterized by a distinctive trizonal architecture, created by lateral shouldering of the junctional component and nests of melanocytes within the dermis that can histologically mimic melanoma, posing a diagnostic dilemma.
We retrospectively identified nine SNPFs (2004-2024) and performed detailed histopathologic and immunohistochemical evaluation.
Patients ranged from 25 to 65 years (median: 41), with lesions most commonly on the trunk.
All cases demonstrated classic trizonal morphology with epidermal flattening, superficial dermal fibroplasia, and deeper dermal nevus nests.
Immunohistochemistry showed uniform PRAME negativity and retained mosaic p16 expression.
Molecular testing was successful in eight of the nine cases, all of which harbored a BRAF V600E mutation (VAF: 1.3%-27%).
SNPFs consistently demonstrate a molecular profile indistinguishable from conventional benign nevi and lack genomic features of melanoma.
These findings provide molecular support for the benign nature of sclerosing nevi with pseudomelanomatous features.