Ultrarapid Staining for Cutaneous Melanoma: Study and Protocol

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BACKGROUND: Immunohistochemistry has revolutionized the use of frozen sections for the removal of melanoma. OBJECTIVE: Two studies were performed to address the best and fastest way to stain melanocytes in frozen tissue sections. MATERIALS AND METHODS: Fifty-six standing cones were taken from sun-damaged white skin and stained with combinations of anti-S-100, anti-HMB-45, anti-Melan-A, and azure B with appropriate controls. RESULTS: Anti-Melan-A was the best immunohistochemical stain. Azure B stains melanin granules metachromatically green and allows differentiation of melanocytes and melanophages. Ultrarapid staining worked as well as rapid staining. CONCLUSION: Dako's EnVision ultrarapid staining protocol and azure B counterstain represent a dramatic improvement and should be considered the easily obtainable histologic standard when excising cutaneous melanoma.