PLA in Practice: Confidence in Gene Expression Testing
by Dr. Simone McKitty | May 29, 2019
Dr. Simone McKitty is a board-certified dermatologist that practices at McKitty Dermatology in Torrance, California. She is an active member of the American Academy of Dermatology, the American Medical Association, the Women’s Dermatologic Society, and the American Society for Dermatologic Surgery.
I had a patient in her early 50’s come in with a nevus that showed some irregular features when evaluated by dermoscopy, so I decided to perform the DermTech PLA. The PLA was gene expression positive for LINC only. Because of this molecular pathology result, I performed a shave biopsy on the lesion. The histopathology came back as a dysplastic nevus with moderate atypia. Here the PLA changed what my treatment plan wouId have been. Since the nevus was gene expression positive (even though single gene LINC positives have a lower correlation to a melanoma diagnosis by histopathology), I wanted to ensure that this lesion was treated as a low-grade melanoma/melanoma in-situ. I referred the patient to plastics and requested an excision with melanoma margins. I am so glad I did! The dermatopathologist diagnosed the lesion as Stage 1a melanoma.
This is one example of how DermTech alters my patient treatment plans, by making me more sensitive, and enabling me to catch more early stage melanoma. I use the PLA on all kinds of lesions that are suspicious of melanoma, including lower risk lesions that I previously may have just monitored.
I chose to add the PLA to my practice because it has a less than 1% chance of missing a melanoma, allows me to avoid unnecessary biopsies, and provides an alternative to my patients that are phobic or fatigued by surgical procedures. This directly benefits my patients’ satisfaction! Genetics is the way of the future and my patients welcome these advances in technology. Most patients would also rather avoid cutting if at all possible.
“This is one example of how DermTech alters my patient treatment plans, by making me more sensitive, and enabling me to catch more early stage melanoma.”
Another benefit is that the kits are at no cost to the dermatologist. This is one of the true value-adds to my practice that comes with zero financial liability. I have been using the PLA in my practice for about two years now and I am happy to recommend it to my fellow dermatology practitioners.