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Clarification Needed on Skin Biopsy Results

Three weeks back, my dermatologist excised a mole she deemed worrisome and sent it for biopsy analysis. I received the results just this evening at 5 PM, moments after the office had closed, and it seems I won’t be able to get an explanation until Thursday. I’m reaching out in hopes that someone can shed some light on these findings for me. From my preliminary online research, I gather that it may be a benign mole; however, I am puzzled by the recommendation for re-excision and the mention of an imperfect PRAME result. **FINAL DIAGNOSIS:** 1. **Skin, Left Mid Upper Back, Shave Procedure:** A. A combined intradermal melanocytic nevus, demonstrating characteristics of both a banal nevus and a common blue nevus (refer to comments for more information). B. The lateral margin shows involvement. **COMMENTARY:** 1. The analysis of the biopsy slides reveals sections of an intradermal melanocytic growth, which consists of a layer of superficial small epithelioid melanocytes with vesicular nuclei situated in the papillary dermis, along with deeper hyperpigmented spindle-shaped melanocytes. The presence of melanocytes is confirmed via SOX-10 staining. However, the PRAME result is technically flawed. BRAF gene testing returned negative, while P16 expression is maintained. Due to the positive margins, it is recommended that a complete re-excision be performed to ensure thorough removal and to avert any risk of recurrence or further progression of the lesion. The reviewing physician concurs with this interpretation. **MICROSCOPIC DETAILS:** The findings at the microscopic level support the provided diagnosis. **GROSS DESCRIPTION:** The first part of the sample is tagged as originating from the left mid upper back (showing pigmentation at the base of the shave, followed by additional shaving and a punch biopsy to eliminate all visible pigment). The specimen comprises three pale tan to tan pieces measuring between 0.2 x 0.2 x 0.1 cm and 0.5 x 0.4 x 0.1 cm, all of which have been fully submitted in a cassette labeled "1A." I'm hoping to better understand what these results imply and the next steps I should consider.

MolesDermatologySkin Cancer
Male25-34
2 days ago