Not missing melanomas in daily practice keeps dermatologists up at night and is a challenge even for dermatologists who see pigmented lesion cases regularly. Ferris et al1 describe the utility of a noninvasive gene expression test capable of differentiating primary melanomas from nonmelanoma pigmented skin lesions. However, neither the article by Ferris et al1 nor the underlying validation study by Gerami et al2 describe scenarios where the LINC00518 and PRAME melanoma gene expression test, termed pigmented lesion assay by the authors, is used in even more difficult cases to diagnose amelanotic melanomas.
Childs MV. Noninvasive Gene Expression Testing in Amelanotic Melanoma. JAMA Dermatol. Published online December 13, 2017. doi:10.1001/jamadermatol.2017.4773