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Σάββατο 22 Ιουνίου 2019

Dermoscopic similarity is an independent predictor of BRAF mutational concordance in multiple melanomas
Elvira Moscarella  Cristina Pellegrini  Riccardo Pampena  Giuseppe Argenziano  Marco Manfredini Claudia Martorelli  Alessia Ciarrocchi  Emi Dika  Ketty Peris  Ambra Antonini … See all authors
First published: 29 April 2019 https://doi.org/10.1111/exd.13951
Moscarella and Pellegrini contributed to this work and should be considered co‐first authors
Funding information:
Dr Pampena is the recipient of a research contract funded by Research Project NET‐2011‐02347213, Italian Ministry of Health.

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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.

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