{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T21:11:55Z","timestamp":1770325915930,"version":"3.49.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n          <jats:p>Conjunctival melanocytic proliferations are diagnostically challenging, often complicated by small specimen size, and are separated into 3 broad categories. The first group includes benign nevi and primary acquired melanosis (PAM) without atypia. The second group includes junctional melanocytic proliferations with a risk of progression to invasive melanoma (PAM with atypia). The last category is conjunctival melanoma, of which 65% of tumors arise in the setting of PAM with atypia. Preferentially expressed antigen in melanoma (PRAME) immunohistochemistry has been widely adopted to differentiate cutaneous nevi and melanoma. However, there are limited studies on its utility in the evaluation of conjunctival melanocytic proliferations with little data regarding its potential utility in stratifying PAM. Twenty-eight clinically annotated cases (14 PAM without atypia and 14 PAM with atypia) were retrospectively evaluated with PRAME\/MART-1 duplex immunohistochemistry and were assigned the commonly used PRAME immunoreactivity score: 0 for no staining, 1+ for 1%\u201325% of cells positive, 2+ for 26%\u201350%, 3+ for 51%\u201375%, and 4+ for &gt;75%. PAM without atypia showed low (0\u20133+) PRAME expression in 14 of 14 cases (100%). PAM with atypia showed strong and diffuse (4+) PRAME expression in 12 of 14 cases (86.7%). Seven of eight (87.5%) PAM with severe atypia, 4 of 4 PAM (100%) with moderate atypia, and 1 of 2 PAM (50%) with mild atypia showed 4+ PRAME expression. In addition, all 5 cases that recurred or progressed (all classified as PAM with atypia) showed 4+ PRAME expression. Although additional larger studies are needed, PRAME seems to be a useful adjunct in evaluating junctional melanocytic proliferations of the conjunctiva.<\/jats:p>","DOI":"10.1097\/dad.0000000000002201","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T16:46:54Z","timestamp":1651078014000},"page":"734-740","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["PRAME Expression in Junctional Melanocytic Proliferations of the Conjunctiva: A Potential Biomarker for Primary Acquired Melanosis\/Conjunctival Melanocytic Intraepithelial Lesions"],"prefix":"10.1097","volume":"44","author":[{"given":"Yuan Y.","family":"Huang","sequence":"first","affiliation":[{"name":"Pathology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Hrycaj","sequence":"additional","affiliation":[{"name":"Pathology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May P.","family":"Chan","sequence":"additional","affiliation":[{"name":"Pathology, and"},{"name":"Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, MI;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Stagner","sequence":"additional","affiliation":[{"name":"Department of Pathology, Massachusetts General Hospital, Boston, MA; and"},{"name":"Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Pathology, and"},{"name":"Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, MI;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2504-466X","authenticated-orcid":false,"given":"Scott C.","family":"Bresler","sequence":"additional","affiliation":[{"name":"Pathology, and"},{"name":"Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, MI;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"R2-20250616","article-title":"Conjunctival melanocytic lesions","author":"Bresler","year":"2021","journal-title":"Arch Pathol Lab Med"},{"key":"R3-20250616","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/j.1442-9071.2008.01888.x","article-title":"Conjunctival melanoma and melanosis: a reappraisal of terminology, classification and staging","volume":"36","author":"Damato","year":"2008","journal-title":"Clin Exp Ophthalmol"},{"key":"R4-20250616","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.5858\/2009-0522-RAR.1","article-title":"Melanocytic lesions of the conjunctiva","volume":"134","author":"Zembowicz","year":"2010","journal-title":"Arch Pathol Lab Med."},{"key":"R5-20250616","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S1074-7613(00)80426-4","article-title":"Characterization of an antigen that is recognized on a melanoma showing partial HLA loss by CTL expressing an NK inhibitory receptor","volume":"6","author":"Ikeda","year":"1997","journal-title":"Immunity"},{"key":"R6-20250616","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1097\/PAS.0000000000001134","article-title":"PRAME expression in melanocytic tumors","volume":"42","author":"Lezcano","year":"2018","journal-title":"Am J Surg Pathol."},{"key":"R7-20250616","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/cup.13958","article-title":"The utility of PRAME staining in identifying malignant transformation of melanocytic nevi","volume":"48","author":"Lohman","year":"2021","journal-title":"J Cutan Pathol."},{"key":"R8-20250616","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/cup.14000","article-title":"The utility of PRAME immunohistochemistry in the evaluation of challenging melanocytic tumors","volume":"48","author":"Alomari","year":"2021","journal-title":"J Cutan Pathol."},{"key":"R9-20250616","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/cup.13818","article-title":"PRAME expression in melanocytic proliferations with intermediate histopathologic or spitzoid features","volume":"47","author":"Raghavan","year":"2020","journal-title":"J Cutan Pathol."},{"key":"R10-20250616","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/PAS.0000000000001393","article-title":"Immunohistochemistry for PRAME in the distinction of nodal nevi from metastatic melanoma","volume":"44","author":"Lezcano","year":"2020","journal-title":"Am J Surg Pathol."},{"key":"R11-20250616","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1097\/PAS.0000000000001492","article-title":"Comparison of immunohistochemistry for PRAME with cytogenetic test results in the evaluation of challenging melanocytic tumors","volume":"44","author":"Lezcano","year":"2020","journal-title":"Am J Surg Pathol."},{"key":"R12-20250616","doi-asserted-by":"crossref","first-page":"59209","DOI":"10.18632\/oncotarget.10962","article-title":"Epigenetic reprogramming and aberrant expression of PRAME are associated with increased metastatic risk in class 1 and class 2 uveal melanomas","volume":"7","author":"Field","year":"2016","journal-title":"Oncotarget"},{"key":"R13-20250616","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1158\/1078-0432.CCR-15-2071","article-title":"PRAME as an independent biomarker for metastasis in uveal melanoma","volume":"22","author":"Field","year":"2016","journal-title":"Clin Cancer Res."},{"key":"R14-20250616","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/jhg.2015.152","article-title":"UV light signature in conjunctival melanoma; not only skin should be protected from solar radiation","volume":"61","author":"Rivolta","year":"2016","journal-title":"J Hum Genet."},{"key":"R15-20250616","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1167\/iovs.17-22517","article-title":"BRAF, NRAS, and GNAQ mutations in conjunctival melanocytic nevi","volume":"59","author":"Francis","year":"2018","journal-title":"Invest Ophthalmol Vis Sci."},{"key":"R16-20250616","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1136\/bjo.2009.167445","article-title":"Expression of MCSP and PRAME in conjunctival melanoma","volume":"94","author":"Westekemper","year":"2010","journal-title":"Br J Ophthalmol."},{"key":"R17-20250616","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1111\/cup.14078","article-title":"PRAME immunohistochemistry is useful in the evaluation of conjunctival melanomas, nevi, and primary acquired melanosis","volume":"48","author":"LeBlanc","year":"2021","journal-title":"J Cutan Pathol."},{"key":"R18-20250616","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1111\/his.14452","article-title":"PRAME expression in melanocytic lesions of the conjunctiva","volume":"79","author":"\u0160ekoranja","year":"2021","journal-title":"Histopathology"},{"key":"R20-20250616","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1097\/PAS.0b013e3181a1ef36","article-title":"Fluorescence in situ hybridization (FISH) as an ancillary diagnostic tool in the diagnosis of melanoma","volume":"33","author":"Gerami","year":"2009","journal-title":"Am J Surg Pathol."},{"key":"R21-20250616","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1600-0560.2009.01488.x","article-title":"Distinction of conjunctival melanocytic nevi from melanomas by fluorescence in situ hybridization","volume":"37","author":"Busam","year":"2010","journal-title":"J Cutan Pathol."},{"key":"R22-20250616","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1136\/bjophthalmol-2012-302261","article-title":"Fluorescence in situ hybridisation (FISH) in histologically challenging conjunctival melanocytic lesions","volume":"97","author":"Mudhar","year":"2013","journal-title":"Br J Ophthalmol."},{"key":"R23-20250616","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/8828579","article-title":"Clinicopathological and prognostic significance of PRAME overexpression in human cancer: a meta-analysis","volume":"2020","author":"Li","year":"2020","journal-title":"Biomed Res Int."}],"container-title":["The American Journal of Dermatopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/DAD.0000000000002201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T19:00:28Z","timestamp":1750100428000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/DAD.0000000000002201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,11]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/dad.0000000000002201","relation":{},"ISSN":["0193-1091"],"issn-type":[{"value":"0193-1091","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4,11]]}}}