{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:59:55Z","timestamp":1782493195554,"version":"3.54.5"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec id=\"ab-dbr230027-4\"><jats:title>Importance<\/jats:title><jats:p>Pathologic assessment to diagnose skin biopsies, especially for cutaneous melanoma, can be challenging, and immunohistochemistry (IHC) staining has the potential to aid decision-making. Currently, the temporal trends regarding the use of IHC for the examination of skin biopsies on a national level have not been described.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr230027-5\"><jats:title>Objective<\/jats:title><jats:p>To illustrate trends in the use of IHC for the examination of skin biopsies in melanoma diagnoses.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr230027-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A retrospective cross-sectional study was conducted to examine incident cases of melanoma diagnosed between January 2000 and December 2017. The analysis used the SEER-Medicare linked database, incorporating data from 17 population-based registries. The study focused on incident cases of in situ or malignant melanoma of the skin diagnosed in patients 65 years or older. Data were analyzed between August 2022 and November 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr230027-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcomes encompassed the identification of claims for IHC within the month of melanoma diagnoses and extending up to 14 days into the month following diagnosis. The SEER data on patients with melanoma comprised demographic, tumor, and area-level characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr230027-8\"><jats:title>Results<\/jats:title><jats:p>The final sample comprised 132\u202f547 melanoma tumors in 116\u202f117 distinct patients. Of the 132\u202f547 melanoma diagnoses meeting inclusion criteria from 2000 to 2017, 43\u202f396 cases had accompanying IHC claims (33%). Among these cases, 28\u202f298 (65%) were diagnosed in male patients, 19\u202f019 (44%) were diagnosed in patients aged 65 years to 74 years, 16\u202f444 (38%) in patients aged 75 years to 84 years, and 7933 (18%) in patients aged 85 years and older. In 2000, 11% of melanoma cases had claims for IHC at or near the time of diagnosis. This proportion increased yearly, with 51% of melanoma cases having associated IHC claims in 2017. Increasing IHC use is observed for all stages of melanoma, including in situ melanoma. Claims for IHC in melanomas increased in all 17 SEER registries but at different rates. In 2017, the use of IHC for melanoma diagnosis ranged from 39% to 68% across registries.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr230027-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Considering the dramatically rising and variable use of IHC in diagnosing melanoma by pathologists demonstrated in this retrospective cross-sectional study, further investigation is warranted to understand the clinical utility and discern when IHC most improves diagnostic accuracy or helps patients.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.6417","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T16:01:17Z","timestamp":1709740877000},"page":"434","source":"Crossref","is-referenced-by-count":15,"title":["Immunohistochemistry for Diagnosing Melanoma in Older Adults"],"prefix":"10.1001","volume":"160","author":[{"given":"Kenechukwu","family":"Ojukwu","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan M.","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adewole S.","family":"Adamson","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Dell Medical School, The University of Texas at Austin"},{"name":"Deputy Editor and Web Editor, JAMA Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen F.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Piepkorn","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle"},{"name":"Dermatopathology Northwest, Bellevue, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Murdoch","sequence":"additional","affiliation":[{"name":"Dermatopathology Northwest, Bellevue, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond L.","family":"Barnhill","sequence":"additional","affiliation":[{"name":"Department of Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and Faculty of Medicine University of Paris Descartes, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stevan R.","family":"Knezevich","sequence":"additional","affiliation":[{"name":"Pathology Associates, Clovis, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joann G.","family":"Elmore","sequence":"additional","affiliation":[{"name":"Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"dbr230027r1","doi-asserted-by":"publisher","first-page":"j2813","DOI":"10.1136\/bmj.j2813","article-title":"Pathologists\u2019 diagnosis of invasive melanoma and melanocytic proliferations: observer accuracy and reproducibility study.","volume":"357","author":"Elmore","year":"2017","journal-title":"BMJ"},{"issue":"1","key":"dbr230027r2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/DAD.0b013e31825d4f73","article-title":"Utilization and utility of immunohistochemistry in 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Number of persons by race and Hispanic ethnicity for SEER participants. 2020. 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