The following is a summary of “An Update and Review of Clinical Outcomes Using Immunohistochemical Stains in Mohs Micrographic Surgery for Melanoma,” published in the January 2024 issue of Dermatology by Elgash, et al.
Mohs micrographic surgery (MMS) gives the best control over your margins by checking both the edges and the inside of them. In the past, it was hard to use MMS to treat melanoma because it was hard to figure out what the melanocytes on frozen pieces meant. Immunohistochemical (IHC) screening, a method that uses chromogen-tagged antibodies to find proteins of interest, has changed the way melanoma is surgically treated.
For a study, researchers sought to give an update and literature review of the latest IHC stains used in MMS to look for melanoma, including how well they work in the clinic and what their sensitivity and specificity are.
Some of the words that were used in the PubMed search were “immunohistochemistry,” “staining,” and “Mohs surgery.” It included articles about how IHC stains can be used to treat cancer with MMS. Six IHC stains met the review requirements. These were MART-1, which is an antigen for melanoma that is recognized by T cells, SOX10, which is an antigen for a microphthalmia-associated transcription factor, HMB-45, MEL-5, and S-100, and an antigen that is particularly expressed in melanoma.
After IHC methods were changed to work with frozen parts, MMS became the best way to treat melanoma in certain places. More research was needed to make IHC methods more consistent and to figure out the best ways to use frozen sections to treat melanoma.
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