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Dermoscopy and confocal microscopy for metachronous multiple melanomas: morphological, clinical, and molecular correlations

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

Cutaneous melanoma is one of the most frequent malignancies of the skin in Caucasian populations. Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. The estimated incidence of multiple primary melanoma (MPM) ranges from 1.2% to 8.2% of cases, with a high preponderance of melanomas occurring metachronously.

Objectives

The aim of this study was to describe dermoscopic, microscopic, clinical, and molecular correlations between first and subsequent melanomas in patients with metachronous MPMs.

Materials & Methods

Twenty-four paired melanomas from 12 MPM patients were evaluated for architectural characteristics based on dermoscopy and confocal microscopy, as well as for mutations in BRAF and NRAS genes by Sanger-based sequencing analysis. Specific scores used for classifying features of dermoscopy (global pattern; 7-point check list; ABCD Stolz score) and confocal microscopy (Segura and Pellacani) were compared with genetic and histological data.

Results

Consistency in dermoscopic patterns between the primary and subsequent cutaneous melanomas were observed in about two thirds of cases, whereas concordant features based on confocal microscopy were found in only about two fifths of cases. The majority of patients (7/12; 58%) presented consistent BRAF/NRAS mutation patterns between first and subsequent primary melanomas. A significant association between BRAF mutations and Pellacani scorewas evident.

Conclusions

Similarities between the index melanoma and subsequent cutaneous melanomas were observed with regards to dermoscopic features and, to a much less extent, confocal microscopy findings. Our data further indicate that the Pellacani score may be used to predict BRAF mutations.

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Author notes

  1. These authors contributed equally

Authors and Affiliations

  1. Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, 07100, Sassari, Italy

    Maria Colombino, Maria Cristina Sini, Antonella Manca, Milena Casula & Giuseppe Palmieri

  2. Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy

    Panagiotis Paliogiannis & Ignazio Stanganelli

  3. Dermatologic Unit, University of Parma, 43121, Parma, Italy

    Calogero Pagliarello

  4. Anatomic Pathology Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Via Matteotti 64, 07100, Sassari, Italy

    Antonio Cossu, Amelia Lissia & Valentina Doneddu

  5. Dermatology Unit, Department of Clinical and Experimental Medicine, University of Sassari, V.le San Pietro 43, 07100, Sassari, Italy

    Rosanna Satta

  6. Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy

    Laura Mazzoni, Serena Magi & Ignazio Stanganelli

Authors
  1. Maria Colombino
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  2. Panagiotis Paliogiannis
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  3. Calogero Pagliarello
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  4. Antonio Cossu
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  5. Amelia Lissia
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  6. Rosanna Satta
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  7. Laura Mazzoni
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  8. Serena Magi
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  9. Maria Cristina Sini
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  10. Antonella Manca
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  11. Milena Casula
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  12. Valentina Doneddu
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  13. Giuseppe Palmieri
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  14. Ignazio Stanganelli
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Consortia

Italian Melanoma Intergroup (IMI)

Corresponding author

Correspondence to Antonio Cossu.

Additional information

IMI includes the following additional members who participated as investigators in this study and should be considered as co-authors: Gerardo Botti and Corrado Caracò (Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy), Vanna Chiarion Sileni (Istituto Oncologico Veneto, Padova, Italy), Anna Maria Di Giacomo (Azienda Ospedaliera Universitaria Senese, Siena, Italy), Mario Mandalà (Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy), Pietro Quaglino (Azienda Ospedaliera Universitaria Città Salute e Scienza, Torino, Italy), and Paola Queirolo (Azienda Ospedaliera Universitaria San Martino, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy)

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Colombino, M., Paliogiannis, P., Pagliarello, C. et al. Dermoscopy and confocal microscopy for metachronous multiple melanomas: morphological, clinical, and molecular correlations. Eur J Dermatol 28, 149–156 (2018). https://doi.org/10.1684/ejd.2017.3206

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  • DOI: https://doi.org/10.1684/ejd.2017.3206

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