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Cutaneous Malignant Melanoma: Update on Diagnostic and Prognostic Biomarkers

Abbas, Ossama MD*; Miller, Daniel D. MD; Bhawan, Jag MD

The American Journal of Dermatopathology: May 2014 - Volume 36 - Issue 5 - p 363–379
doi: 10.1097/DAD.0b013e31828a2ec5
CME Article

Abstract: The incidence of cutaneous malignant melanoma has rapidly increased in recent years in all parts of the world, and melanoma is a leading cause of cancer death. As even relatively small melanomas may have metastatic potential, accurate assessment of progression is critical. Although diagnosis of cutaneous malignant melanoma is usually based on histopathologic criteria, these criteria may at times be inadequate in differentiating melanoma from certain types of benign nevi. As for prognosis, tumor (Breslow) thickness, mitotic rate, and ulceration have been considered the most important prognostic indicators among histopathologic criteria. However, there are cases of thin primary melanomas that have ultimately developed metastases despite complete excision. Given this, an accurate assessment of melanoma progression is critical, and development of molecular biomarkers that identify high-risk melanoma in its early phase is urgently needed. Large-scale genomic profiling has identified considerable heterogeneity in melanoma and suggests subgrouping of tumors by patterns of gene expression and mutation will ultimately be essential to accurate staging. This subgrouping in turn may allow for more targeted therapy. In this review, we aim to provide an update on the most promising new biomarkers that may help in the identification and prognostication of melanoma.

*Associate Professor of Clinical Dermatology, Dermatology Department, American University of Beirut-Medical Center, Beirut, Lebanon; and

Assistant Professor of Dermatology (D.D.M.), Professor of Dermatology and Pathology (J.B.), Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA.

Reprints: Jag Bhawan, MD, Dermatopathology Section, Dermatology Department, Boston University School of Medicine, 609 Albany Street, J-309, Boston, MA 02118-2415 (e-mail:

© 2014 by Lippincott Williams & Wilkins.