TOTAL BODY PHOTOGRAPHY FOR PATIENTS ON BRAF INHIBITORS

NEW YORK (Reuters Health) - Total-body photography and dermoscopy are helpful for monitoring atypical pigmented lesions in patients taking BRAF inhibitors, researchers suggest.

These patients tend to have highly volatile melanocytic changes, they say.

While BRAF inhibitors "can theoretically cure patients of their BRAF-mutated melanoma . . . BRAF wild-type melanomas remain a challenge," the authors add - and many of the neoplasms in this population BRAF wild-type.

"Be particularly vigilant for new and changing lesions within the first six to 12 months after start of BRAF-inhibitors. Most changes and most new primary melanomas develop within six to eight months after staring BRAF-inhibitors. Thus, more frequent follow-up visits during this early period may be prudent, especially in patients with the dysplastic nevus syndrome," Dr. Ashfaq Marghoob, an attending physician of dermatology at Memorial Sloan Kettering Cancer Center in Hauppauge, New York, who led the study, told Reuters Health by email.

Dr. Marghoob and his team published their findings online July 23 in a research letter to JAMA Dermatology.

The researchers took photos and dermoscopy of 13 patients to evaluate changes in moles at baseline and more than ten months later for follow up. "The mean number of combined new and growing and/or darkening melanocytic lesions (ML) across anatomic locations was between 6.1 and 16.4, and the mean number of involuting MLs across anatomic locations was between 3.4 and 8.0," the authors reported.

The incidence of new melanomas was 435 per 1000 person-years of BRAF inhibitor therapy, according to the report. More than 80% of the melanocytic lesions discovered were benign, but 17% were melanomas.

There was no difference in exposure times to BRAF inhibitor between patients who developed melanomas and those who did not, nor was there a correlation between number of new melanomas and length of exposure to the medication.

Not all patients would require photos and dermoscopy to monitor changes in their moles, however, Dr. Marghoob says.

"It is relatively easy to notice new and changing lesions on a background of few nevi and thus patients with few to no nevi are easy to follow without baseline photography. In patients with many nevi it becomes difficult to detect new and changing lesions. In addition, patients with many nevi are at much higher risk for developing multiple primary melanomas as compared to patients with few nevi," Dr. Marghoob says.

SOURCE: http://bit.ly/1qyCeXo