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Second primary melanomas under BRAF blockers: study by Reflectance Confocal Microscopy.
MedLine Citation:
PMID:  23302038     Owner:  NLM     Status:  Publisher    
BACKGROUND: New primary melanomas arising in stage IV melanoma patients under BRAF inhibitors have been recently reported. This raises the question of the nature of the earliest cellular events identifiable within pre-existing moles. Objectives: to use RCM to investigate changing moles in patients under Vemurafenib. METHODS: In the first part of the study, 23 lesions were examined by RCM before excision (performed because of digital dermoscopy changes) and histopathological examination. In the second part, 10 randomly chosen lesions in 2 patients were examined before and after 3 months of treatment. RESULTS: the first step permitted to highlight an unusual RCM pattern identified in 5 lesions characterized by areas of marked atypias in otherwise non dysplastic lesions. In the second step, four initially non dysplastic lesions developed focal or multifocal areas of marked atypias under treatment that were not always correlated with digital dermoscopy changes, but correlated with histopathology. All 4 lesions were finally diagnosed as melanomas. CONCLUSIONS: Although the clinical relevance of such findings remains questionable, RCM allowed to observe, at cellular level, the earliest events occurring within Vemurafenib-induced changing moles. Moreover repeated RCM examinations permitted to confirm that microscopic marked atypias that led to the histopathological diagnosis of melanoma appeared under treatment and were not preexisting.
S Debarbieux; S Dalle; L Depaepe; N Poulalhon; B Balme; L Thomas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  The British journal of dermatology     Volume:  -     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©The Authors BJD © 2013 British Association of Dermatologists.
Dermatology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon and Claude Bernard University Lyon 1, France.
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