The goal of early melanoma detection is to biopsy melanomas before they become invasive and avoid unnecessary biopsies of benign pigmented lesions.1 Noninvasive gene expression profile testing has the potential to serve both purposes by improving clinical diagnostic accuracy and informing biopsy decision making. The Pigmented Lesion Assay (PLA) (DermTech, La Jolla, CA) involves tape-stripping lesions to obtain stratum corneum from which RNA is isolated and expression levels of the noncoding long RNA Linc00518 (Linc) and PRAME genes are assessed.2 Lesions showing elevated expression levels of both Linc and PRAME, either Linc or PRAME, or neither gene are interpreted as high, moderate, or low risk, respectively.2 In a validation study of 398 pigmented lesions, Gerami and colleagues3 reported that the PLA test had a 91% sensitivity and 69% specificity for histologic diagnosis of melanoma. Reports of the diagnostic performance of the PLA test have been limited to individual lesions from separate patients. To our knowledge, its utility in screening patients with numerous clinically atypical pigmented lesions has not been described.
