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One curious characteristic of the Spitz tumor pathway is inactivation of CDKN2A (often the only genetic alteration), with loss of p16 expression, which would be of concern in melanocytic tumors in any other pathway.47 Therefore, malignant transformation requires other mutations in addition to inactivation of CDKN2A, for example, TERT promoter mutations

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A follow-up trial has sought to evaluate the safety of subcutaneous bioresorbable implants of melanotan I but results from this trial are unavailable [9]