Dermoscopic similarity is an independent predictor of BRAF mutational concordance in multiple melanomas

Abstract

Background The association of clinical and dermoscopic features with BRAF mutational status has been poorly analysed in multiple primary melanomas (MPM). Objective To investigate whether concordance of BRAF mutational status is associated with dermoscopic similarity in multiple melanomas of the same patient. Methods Dermoscopic images and corresponding tissue sections of 124 melanomas from 62 patients with MPM were selected at four Italian Dermatology Departments. Similarity of dermoscopic appearance between multiple melanomas was evaluated according to the presence of the same prevalent dermoscopic feature. The BRAFV600 mutational status was analysed with allele‐specific TaqManTM assays or pyrosequencing. Spearman's correlation and univariate and multivariate regression analysis were used for statistical analysis. Results A similar dermoscopic appearance was identified in 38.7% (24/62) of patients with MPM and was correlated with older age at first diagnosis (rho: 0.26; P: 0.042) and occurrence on sun‐damaged skin (rho: 0.27; P: 0.037). The BRAFV600 mutation was detected in 39.5% (49/124) of the tumors and a concordant BRAF mutational status between melanomas in 33/62 (53.2%) MPM patients. Dermoscopically similar melanomas showed 5.7‐fold higher odds to be concordant for BRAF mutational status compared to dissimilar lesions (OR: 5.7; 95% CI 1.7‐19.5; P: 0.005). Conclusion Dermoscopic similarity of multiple melanomas represents an independent clinical predictor of a concordant BRAF mutational status in MPM patients.

Multiple primary melanomas: Is there a correlation between dermoscopic features and germline mutations?

“…Moscarella et al reported a concordance rate respectively in 53.0% and 38.7% of MPMs 8 . Colombino et al reported a higher concordance rate (66.7%) but limited to only 12 patients.…”

Utilization of Imaging Modalities in the Diagnosis of Melanoma: A Scoping Review

“…Dermoscopic features may also overlap in lesions with similar pathologic origin. A percentage (38.7%) of patients with multiple primary melanomas were found to have similar dermoscopic features, and these melanomas showed 5.7x higher odds to share the same BRAF mutational status [ 17 ]. However, dermoscopy, like all imaging techniques, has its limitations.…”

Immunohistochemical mismatch repair proteins expression as a tool to predict the melanoma immunotherapy response

“…MSI was described in displastic naevi, MMs and MM metastases, suggesting that the MMR system and consequently MSI could contribute to the pathogenesis of MM (17). Differently to colon cancer and other solid malignancies that are treated with immunotherapy (1,18,19), potential IHC biomarkers are still limited for MM up to now. This lack of predictive biomarkers for immunotherapy response in MM patients is today an important field of investigation, whose aim is to allow a personalized therapeutic approach.…”