title: Melanoma patients under vemurafenib: prospective follow-up of melanocytic lesions by digital dermoscopy.
abstract: Second primary melanomas (SPMs) induced by vemurafenib have been recently described. The aim of this study was to define the dermoscopical signs of melanoma in this context. Patients underwent a total body examination before receiving vemurafenib. Each single melanocytic lesion was registered before therapy by digital dermoscopy (DD), and then repeated monthly until therapy disruption. Forty-two patients were included, the mean duration of follow-up was 6.7 months, and a mean number of 51 lesions per patients were captured and followed. A total number of 2,155 lesions were recorded, of which 56.1% presented at least one change during the study. More common changes concerned the color of the lesions (up to 15%) and appearance or disappearance of globules (14.6%). Thirty-six of the melanocytic lesions were surgically excised, 21 were classified as a nevus, 1 was a lentigo, and 14 as a second new primary melanoma (occurring in 21% of our patients). DD allowed us to excise only 36/2,155 (1.6%) of the lesions and permitted us to detect 14 SPM in the 42 patients with a highly efficient malignant/benign ratio of 63.6%. Although vemurafenib is now tested in an adjuvant setting DD should be systematically used in order to accurately detect SPM and reduce the number of unnecessary excisions.
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Perier-Muzet
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Poulalhon
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Debarbieux
authors.affiliation: Université Claude Bernard Lyon 1, Lyon, France; Cancer Research Center of Lyon, Lyon, France; Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Pierre-Paul
authors.initials: PP
authors.lastname: Bringuier
authors.affiliation: Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Duru
authors.affiliation: Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Lauriane
authors.initials: L
authors.lastname: Depaepe
authors.affiliation: Unit of Pathology, Centre Hospitalier Lyon-Sud, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Balme
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Cancer Research Center of Lyon, Lyon, France. Electronic address: stephane.dalle@chu-lyon.fr.
authors.forename: Stephane
authors.initials: S
authors.lastname: Dalle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D007911:Lentigo / Q000139:chemically induced / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008544:Melanocytes / Q000187:drug effects / Q000473:pathology; D008545:Melanoma / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000473:pathology*; D009508:Nevus, Pigmented / Q000139:chemically induced / Q000473:pathology; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology; D012880:Skin Pigmentation / Q000187:drug effects; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects*; D000077484:Vemurafenib
chemical_list: D004791:Enzyme Inhibitors; D007211:Indoles; D013449:Sulfonamides; D000077484:Vemurafenib