Conflicts of interest None declared.
Dermoscopic features of melanomas associated with MC1R variants in Spanish CDKN2A mutation carriers
Version of Record online: 15 SEP 2008
© 2008 The Authors. Journal Compilation © 2008 British Association of Dermatologists
British Journal of Dermatology
Volume 160, Issue 1, pages 48–53, January 2009
How to Cite
Cuéllar, F., Puig, S., Kolm, I., Puig-Butille, J., Zaballos, P., Martí-Laborda, R., Badenas, C. and Malvehy, J. (2009), Dermoscopic features of melanomas associated with MC1R variants in Spanish CDKN2A mutation carriers. British Journal of Dermatology, 160: 48–53. doi: 10.1111/j.1365-2133.2008.08826.x
F.C., S.P. and I.K. contributed equally to the development of the manuscript.
- Issue online: 15 DEC 2008
- Version of Record online: 15 SEP 2008
- Accepted for publication 7 July 2008
- red hair;
- total dermoscopy score
Background The presence of at least one MC1R gene variant is associated with a reduction in age at melanoma diagnosis in families with CDKN2A mutations.
Objectives To describe dermoscopic features of early melanoma in CDKN2A gene mutation-positive Spanish individuals and to evaluate the possibility of a correlation between particular dermatoscopic pattern and MC1R gene variants.
Methods Patients in whom a melanoma was diagnosed during specific follow up of high-risk individuals carrying CDKN2A mutations (with familial or personal history of previous melanoma) were included in this study. The decision to remove such melanomas was taken on the basis of history, clinical and dermoscopic evaluations including total body photography and digital dermoscopy.
Results Of the nine patients included in this study, three were noncarriers of the red hair MC1R polymorphism, three patients had one red hair MC1R polymorphism and three patients had two red hair MC1R polymorphisms. On dermoscopic analysis of suspect melanocytic lesions we found that the mean ± SD ABCD total dermoscopy score (TDS) was significantly higher in noncarriers of red hair MC1R polymorphisms than in carriers of two MC1R gene red hair variants (6·8 ± 0·4 vs. 4·4 ± 0·9; P = 0·014).
Conclusions Early melanomas in patients with two MC1R red hair variants may be difficult to diagnose definitively by dermoscopy because, in our limited experience, they show fewer colours and structures and have a lower TDS. In such melanomas, subtle atypical vessels and other changes detected by digital image follow up may be useful to confirm the diagnosis of melanoma. An integrated approach including clinical history and dermoscopic data (also considering additional information, such as the presence of atypical vessels) should be utilized in evaluating these high-risk patients. Further studies are necessary to confirm our suggestion.