The following is a summary of “Assessment of lipid and pigment content in suspicious melanocytic lesions to improve melanoma detection,” published in the August 2023 issue of Dermatology by Amara et al.
Melanoma is the most frequently fatal malignancy dermatologists diagnose and the most aggressive form of skin cancer. Although advancements have been made in predicting the prognosis of melanoma, there are few susceptible and specific diagnostic instruments for clinically evaluating suspicious melanocytic lesions before biopsy. Recent research has linked cellular lipid and pigment content alterations to tumor progression and melanoma metastasis.
This study aims to determine whether lipid droplet and pigment content evaluations near the skin’s surface can distinguish benign from malignant melanocytic lesions. Boston Medical Center provided us with 14 benign melanocytic lesions, categorized as Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) class 1, and 22 malignant melanomas, classified as MPATH-Dx class 4 or 5. The average most significant thickness of the malignant melanomas was 1.8 ±2.1 mm, and 7/22 specimens revealed ulceration. Tissues were stained with the Fontana Masson stain to detect pigment or with an immunohistochemical stain for adipophilin, the principal protein component of lipid droplets, to see lipid droplets.
ImageJ and CellProfiler were used to quantify pigment and lipid droplets, respectively. The researchers observed no significant difference in total pigment area between benign melanocytic lesions and malignant melanoma, as well as a 66% decrease in lipid content and a 68% decrease in lipid/pigment content (P<0.05). Their findings suggest that lipid content and lipid/pigment ratios can distinguish benign from malignant melanocytic lesions, which may be helpful as a diagnostic tool for pigmented lesions that are difficult to diagnose histopathologically.