23-Gene Expression Profiling Accurately Classifies Pediatric Melanocytic Lesions

A 23-gene expression profiling assay accurately distinguished benign nevi from melanoma in pediatric patients, according to “23-GEP Accurately Distinguishes Between Melanocytic Nevi and Melanoma in Pediatric Melanocytic Neoplasms,” a poster by Drazen Jukic, MD, et al presented as part of the “Best of the Best at Maui Derm” late breakers session at Maui Derm Hawaii 2026.

In a cohort of 201 pediatric lesions, the test demonstrated 92.3% sensitivity and 86.1% specificity, with performance metrics comparable to those reported in all-age cohorts. Intermediate results were observed in 11.4% of cases.

“The 23-GEP accuracy metrics support use in pediatric patients,” the authors noted, emphasizing the diagnostic challenges associated with pediatric melanocytic neoplasms.

The findings support integration of molecular testing with clinical and histopathologic assessment to aid diagnosis in difficult pediatric cases.

“As a practical matter, I hate biopsying children,” said Linda Stein Gold, MD. “If we have a molecular test that helps us determine whether a lesion is malignant or benign, that can be an important piece of the diagnostic puzzle.”

Jason E. Hawkes, MD, emphasized the value in ambiguous cases.

“When pathology comes back as ‘atypical’ and we’re not sure what to do next,” he said, “having another layer of objective data could meaningfully guide clinical decision-making.”