Association between dermoscopic and reflectance confocal microscopy features of cutaneous melanoma with BRAF mutational status

J Eur Acad Dermatol Venereol. 2017 Apr;31(4):643-649. doi: 10.1111/jdv.14028. Epub 2016 Nov 14.

Abstract

Background: Melanomas harbouring common genetic mutations might share certain morphological features detectable with dermoscopy and reflectance confocal microscopy. BRAF mutational status is crucial for the management of metastatic melanoma.

Objectives: To correlate the dermoscopic characteristics of primary cutaneous melanomas with BRAF mutational status. Furthermore, a subset of tumours has also been analysed for the presence of possible confocal features that might be linked with BRAF status.

Methods: Retrospectively acquired dermoscopic and confocal images of patients with melanoma in tertiary referral academic centres: Skin Cancer Unit in Reggio Emilia and at the Melanoma Unit in Barcelona. Kruskal-Wallis test, logistic regressions, univariate and multivariate analyses have been performed to find dermoscopic and confocal features significantly correlated with BRAF mutational status.

Results: Dermoscopically, the presence of irregular peripheral streaks and ulceration were positive predictors of BRAF-mutated melanomas with a statistically significance value, while dotted vessels were more represented in wild-type melanomas. None of the evaluated reflectance confocal microscopy features were correlated with genetic profiling.

Conclusions: Ulceration and irregular peripheral streaks represent dermoscopic feature indicative for BRAF-mutated melanoma, while dotted vessels are suggestive for wild-type melanoma.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Dermoscopy*
  • Female
  • Humans
  • Male
  • Melanoma / diagnostic imaging*
  • Melanoma / genetics*
  • Melanoma / pathology
  • Microscopy, Confocal / methods
  • Middle Aged
  • Mutation
  • Proto-Oncogene Proteins B-raf / genetics*
  • Retrospective Studies
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / genetics*
  • Skin Neoplasms / pathology
  • Skin Ulcer / diagnostic imaging
  • Skin Ulcer / etiology

Substances

  • Proto-Oncogene Proteins B-raf