Oh, what a revelation! It turns out that when you’re slicing and dicing skin during Mohs surgery for melanoma, you might just stumble upon some other skin “surprises” that aren’t melanoma. And guess what? If you’re not up to speed on your melanoma antigen recognized by T cells (MART-1) immunohistochemistry (IHC) staining patterns, you might just go on a wild goose chase, cutting out more than you need to. Oops!

So, in a stunning display of common sense, some intrepid researchers decided to do a comprehensive review (because who doesn’t love a good library session?) of frozen-section histopathology slides from 2021 to 2023. They were on a mission to characterize those pesky incidental lesions that pop up when you’re just trying to deal with melanoma.

And lo and behold, they found that these incidental party crashers can be benign or malignant, and they have the audacity to sometimes stain with MART-1 just like melanoma. But fear not! With a keen eye, you can spot the differences on good ol’ hematoxylin and eosin (H&E) staining. And if you’re really on your game, you’ll notice they lack the histopathologic criteria for melanoma on MART-1 IHC.

The moral of the story? If you’re armed with H&E and MART-1 IHC, you can tell melanoma to take a hike and leave those innocent bystander lesions alone. And just like that, you save the day by not overdoing it with the scalpel, keeping healthcare costs down, and letting your lab staff focus on the real deal. Bravo!