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

Autores de IIS La Fe

• 

  Rafael Botella Estrada

  Autor

Participantes ajenos a IIS La Fe

• Armengot-Carbo, M
• Nagore, E
• Garcia-Casado, Z

Grupos

• Dermatología y Regeneración Tisular

Abstract

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.

Keywords

• blue-white veil; BRAF; dermatology; dermoscopy; exophytic papillary structures; genetics; melanoma; oncology; pathology; ulceration; streaks