The association between dermoscopic features and BRAF mutational status in cutaneous melanoma: Significance of the blue-white veil.

J Am Acad Dermatol 2018 05 4;78(5):920-926.e4. Epub 2018 Jan 4.

Hospital Universitari i Politècnic La Fe [University and Polytechnic Hospital La Fe], València, Spain; Universitat de València [University of Valencia], València, Spain.

Background: The genetic basis of melanoma affects its clinicopathologic characteristics and increasingly influences its management. B-Raf proto-oncogene, serine/threonine kinase gene (BRAF)-mutated melanoma may present with specific dermoscopic features.

Objectives: To identify the dermoscopic features associated with BRAF mutation in cutaneous melanoma and to evaluate a model capable of predicting BRAF mutations on the basis of dermoscopic and clinicopathologic features that are easily accessible in normal clinical practice.

Methods: A prospective, cross-sectional, observational, and descriptive study was performed. A total of 93 cutaneous melanomas with dermoscopic images from 93 patients were included. BRAF mutational status was determined by genetic analysis using 2 methods: cobas 4800 BRAF V600 Mutation Test (Roche Molecular Systems, Pleasanton, CA) and Sanger sequencing. Clinicopathologic data were collected; dermoscopic images were analyzed by 2 independent blind observers.

Results: Blue-white veil in dermoscopy was significantly associated with BRAF mutations (odds ratio, 4.3; 95% confidence interval, 1.6-11.5; P = .003). Patients with BRAF-mutated melanomas were significantly younger than those with wild-type melanomas (odds ratio, 0.96; 95% confidence interval, 0.93-0.99; P = .008). On the basis of these 2 variables, it was possible to predict BRAF mutational status in melanoma with 73% accuracy.

Limitations: Histologic data were obtained from pathology reports. The accuracy of the predictive model has not been tested with a new data set.

Conclusions: Blue-white veil in dermoscopy is associated with BRAF mutations in cutaneous melanoma.

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http://dx.doi.org/10.1016/j.jaad.2017.12.064DOI Listing
May 2018
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