Shot at the dark.

It can seem that’s what derms are doing when selecting pigmented lesions to biopsy during skin checks. Next time ask for the patch. As in a pigmented lesion assay (PLA) patch, an adhesive which collects sufficient DNA from a pigmented lesion to adequately rule out genetic indicators of melanoma. All without a scalpel or punch, might we add. Not to mention the negative predictive value has been shown to increase from 83% with visual assessment (VA) alone to >99% with the patch. Fascinating, but at what cost? Glad you asked. This economic analysis of a CMS database reports the number of lesions needed to biopsy in order to diagnosis one melanoma dropped from 16 with the standard paradigm of VA → biopsy to 3 with the intervening VA → PLA patch → biopsy, translating into a cost savings of approximately $500 per suspicious lesion. TBL: It might not be a bad time to buy stock in PLA patches, and the senior author agrees. | Hornberger, JAMA Dermatol 2018