Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma

F. C. Pozzobon, J. A. Puig-Butillé, T. González-Alvarez, C. Carrera, P. Aguilera, L. Alos, C. Badenas, James M Grichnik, J. Malvehy, S. Puig

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Abstract

BACKGROUND: The identification of BRAF mutations in melanoma led to the development and implementation of new and effective therapies. Few clinical and histological features have been associated with this mutational status.

OBJECTIVES: The main objective of this study was to investigate clinical, histopathological and dermoscopic characteristics of primary melanomas according to BRAF or NRAS mutational status.

METHODS: An observational retrospective study including melanoma dermoscopy images assessed for somatic mutations in BRAF and NRAS.

RESULTS: Seventy-two patients were included, 30 women (42%) and 42 men (58%), mean age was 59 ± 15.51 years. BRAF-mutated melanomas were more frequently located on the trunk (n = 18, 64% for BRAF-mutated vs. n = 11, 29% for wild-type melanomas, P = 0.013). Histological ulceration was associated with the presence of BRAF mutations [odds ratio (OR) 3.141; 95% confidence interval (CI) 1.289-7.655; P = 0.002]. The Breslow index tended to be thicker in BRAF-mutated compared with wild-type (P = 0.086). BRAF mutations were present in 28 (39%) patients and only four cases were positive for NRAS mutations (6%), BRAF and NRAS mutations being mutually exclusive. The presence of dermoscopic peppering was associated with MAPK mutations (BRAF and NRAS) (OR 1.68; 95% CI 1.089-2.581; P = 0.015). Dermoscopic ulceration was also associated with BRAF mutations excluding acral and facial melanomas (OR 2.64; 95% CI 1.032-6.754).

CONCLUSIONS: This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.

Original languageEnglish (US)
Pages (from-to)754-759
Number of pages6
JournalBritish Journal of Dermatology
Volume171
Issue number4
DOIs
StatePublished - Oct 1 2014

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Melanoma
Skin
Mutation
Odds Ratio
Confidence Intervals
Dermoscopy
Dermis
Observational Studies
Extremities
Retrospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pozzobon, F. C., Puig-Butillé, J. A., González-Alvarez, T., Carrera, C., Aguilera, P., Alos, L., ... Puig, S. (2014). Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma. British Journal of Dermatology, 171(4), 754-759. https://doi.org/10.1111/bjd.13069

Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma. / Pozzobon, F. C.; Puig-Butillé, J. A.; González-Alvarez, T.; Carrera, C.; Aguilera, P.; Alos, L.; Badenas, C.; Grichnik, James M; Malvehy, J.; Puig, S.

In: British Journal of Dermatology, Vol. 171, No. 4, 01.10.2014, p. 754-759.

Research output: Contribution to journalArticle

Pozzobon, FC, Puig-Butillé, JA, González-Alvarez, T, Carrera, C, Aguilera, P, Alos, L, Badenas, C, Grichnik, JM, Malvehy, J & Puig, S 2014, 'Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma', British Journal of Dermatology, vol. 171, no. 4, pp. 754-759. https://doi.org/10.1111/bjd.13069
Pozzobon FC, Puig-Butillé JA, González-Alvarez T, Carrera C, Aguilera P, Alos L et al. Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma. British Journal of Dermatology. 2014 Oct 1;171(4):754-759. https://doi.org/10.1111/bjd.13069
Pozzobon, F. C. ; Puig-Butillé, J. A. ; González-Alvarez, T. ; Carrera, C. ; Aguilera, P. ; Alos, L. ; Badenas, C. ; Grichnik, James M ; Malvehy, J. ; Puig, S. / Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma. In: British Journal of Dermatology. 2014 ; Vol. 171, No. 4. pp. 754-759.
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abstract = "BACKGROUND: The identification of BRAF mutations in melanoma led to the development and implementation of new and effective therapies. Few clinical and histological features have been associated with this mutational status.OBJECTIVES: The main objective of this study was to investigate clinical, histopathological and dermoscopic characteristics of primary melanomas according to BRAF or NRAS mutational status.METHODS: An observational retrospective study including melanoma dermoscopy images assessed for somatic mutations in BRAF and NRAS.RESULTS: Seventy-two patients were included, 30 women (42{\%}) and 42 men (58{\%}), mean age was 59 ± 15.51 years. BRAF-mutated melanomas were more frequently located on the trunk (n = 18, 64{\%} for BRAF-mutated vs. n = 11, 29{\%} for wild-type melanomas, P = 0.013). Histological ulceration was associated with the presence of BRAF mutations [odds ratio (OR) 3.141; 95{\%} confidence interval (CI) 1.289-7.655; P = 0.002]. The Breslow index tended to be thicker in BRAF-mutated compared with wild-type (P = 0.086). BRAF mutations were present in 28 (39{\%}) patients and only four cases were positive for NRAS mutations (6{\%}), BRAF and NRAS mutations being mutually exclusive. The presence of dermoscopic peppering was associated with MAPK mutations (BRAF and NRAS) (OR 1.68; 95{\%} CI 1.089-2.581; P = 0.015). Dermoscopic ulceration was also associated with BRAF mutations excluding acral and facial melanomas (OR 2.64; 95{\%} CI 1.032-6.754).CONCLUSIONS: This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.",
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T1 - Dermoscopic criteria associated with BRAF and NRAS mutation status in primary cutaneous melanoma

AU - Pozzobon, F. C.

AU - Puig-Butillé, J. A.

AU - González-Alvarez, T.

AU - Carrera, C.

AU - Aguilera, P.

AU - Alos, L.

AU - Badenas, C.

AU - Grichnik, James M

AU - Malvehy, J.

AU - Puig, S.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - BACKGROUND: The identification of BRAF mutations in melanoma led to the development and implementation of new and effective therapies. Few clinical and histological features have been associated with this mutational status.OBJECTIVES: The main objective of this study was to investigate clinical, histopathological and dermoscopic characteristics of primary melanomas according to BRAF or NRAS mutational status.METHODS: An observational retrospective study including melanoma dermoscopy images assessed for somatic mutations in BRAF and NRAS.RESULTS: Seventy-two patients were included, 30 women (42%) and 42 men (58%), mean age was 59 ± 15.51 years. BRAF-mutated melanomas were more frequently located on the trunk (n = 18, 64% for BRAF-mutated vs. n = 11, 29% for wild-type melanomas, P = 0.013). Histological ulceration was associated with the presence of BRAF mutations [odds ratio (OR) 3.141; 95% confidence interval (CI) 1.289-7.655; P = 0.002]. The Breslow index tended to be thicker in BRAF-mutated compared with wild-type (P = 0.086). BRAF mutations were present in 28 (39%) patients and only four cases were positive for NRAS mutations (6%), BRAF and NRAS mutations being mutually exclusive. The presence of dermoscopic peppering was associated with MAPK mutations (BRAF and NRAS) (OR 1.68; 95% CI 1.089-2.581; P = 0.015). Dermoscopic ulceration was also associated with BRAF mutations excluding acral and facial melanomas (OR 2.64; 95% CI 1.032-6.754).CONCLUSIONS: This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.

AB - BACKGROUND: The identification of BRAF mutations in melanoma led to the development and implementation of new and effective therapies. Few clinical and histological features have been associated with this mutational status.OBJECTIVES: The main objective of this study was to investigate clinical, histopathological and dermoscopic characteristics of primary melanomas according to BRAF or NRAS mutational status.METHODS: An observational retrospective study including melanoma dermoscopy images assessed for somatic mutations in BRAF and NRAS.RESULTS: Seventy-two patients were included, 30 women (42%) and 42 men (58%), mean age was 59 ± 15.51 years. BRAF-mutated melanomas were more frequently located on the trunk (n = 18, 64% for BRAF-mutated vs. n = 11, 29% for wild-type melanomas, P = 0.013). Histological ulceration was associated with the presence of BRAF mutations [odds ratio (OR) 3.141; 95% confidence interval (CI) 1.289-7.655; P = 0.002]. The Breslow index tended to be thicker in BRAF-mutated compared with wild-type (P = 0.086). BRAF mutations were present in 28 (39%) patients and only four cases were positive for NRAS mutations (6%), BRAF and NRAS mutations being mutually exclusive. The presence of dermoscopic peppering was associated with MAPK mutations (BRAF and NRAS) (OR 1.68; 95% CI 1.089-2.581; P = 0.015). Dermoscopic ulceration was also associated with BRAF mutations excluding acral and facial melanomas (OR 2.64; 95% CI 1.032-6.754).CONCLUSIONS: This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.

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