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Betsy N. Perry, MD; Cynthia Cohen, MD; Baskaran Govindarajan, PhD; George Cotsonis, MA; Jack L. Arbiser, MD, PhD

Arch Dermatol. 2006;142:1031-1034.

Background  Pigmented lesions are common, yet they present diagnostic and therapeutic challenges. They range from nevi, which are clinically stable, to melanomas, which are notorious for distant metastasis and death. Both nevi and melanomas arise from melanocytes, which are neural crest derivatives, and melanocyte precursors migrate from the paraspinal area to their eventual location at the dermoepidermal junction. Atypical nevi have been clinically considered to be precursors of melanoma, and recently, biochemical abnormalities have been found that are present in both nevi and melanomas, including inactivation of the p16INK4a tumor suppressor gene and mutations in B-raf. These mutations suggest not only that nevi and melanomas share a common origin but also that additional events are required for transformation to malignant melanoma.

Observations  We performed a Panomics protein array comparing a radial growth melanoma cell line with a vertical growth melanoma cell line and found that the transcription factor Wilms tumor 1 is highly expressed in the vertical growth cell line compared with the radial growth cell line. Using immunohistochemical analysis, we compared expression of archival nevi and melanomas in a tissue microarray.

Conclusion  We found that Wilms tumor 1 is expressed in most melanomas but is nearly absent in nevi. Immunohistochemical analysis for Wilms tumor 1 may be clinically useful in distinguishing nevi from melanoma.

Author Affiliations: School of Medicine, Departments of Dermatology (Drs Perry, Govindarajan, and Arbiser), Pathology and Laboratory Medicine (Dr Cohen), and Rollins School of Public Health (Mr Cotsonis), Emory University, and Department of Dermatology, Veterans Administration Hospital (Dr Arbiser), Atlanta, Ga.

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