The following is the summary of “Clinical Utility of Dermoscopy and 31-Gene Expression Profiling by Dermatology Providers in Melanoma Management Care” published in the December 2022 issue of Dermatology by Witkowski, et al.
Patients with cutaneous malignant melanoma (CMM) now have access to a 31-gene expression profile (31-GEP) test that has been shown to predict their risk of metastasis accurately. The test uses individual differences to categorize patients into those at reduced risk or higher risk, according to their specific gene expression patterns. There has been research into how this type of test influences dermatologists’ clinical judgment, but whether or how dermoscopy and 31-GEP results are linked needs to be better understood.
Researchers used a modified dermoscopy 3 checklist to assess the frequency of dermoscopic features in 17 cases (n=17) and compared these findings to other key clinicopathologic features such as tumor thickness, ulceration, and mitotic rate in this retrospective analysis of 31-GEP test results ordered by dermatologists. Investigators also looked at the dermatologist’s point of view and how they included GEP testing in their discussions with patients about melanoma treatment. Based on the data from the 31-GEP, patients were divided into 4 categories: groups 1A and 1B have a low probability of metastasis or recurrence. Only one case in group 1B (5.6%) and one in group 2B (5.6%) were found among 17 tests.
The most common dermoscopy findings were asymmetry (present in all cases), roundness (47%), and a bluish-white hue (70.6%). Providers often spent 15 minutes (10-20 minutes) explaining and ordering the test. Study group concluded that dermatologists should consider ordering the 31-GEP test for newly diagnosed CMM patients based on their experience and awareness of the dermatologist’s role in the care pathway of melanoma patients.