Clinical and Dermoscopic Features of Cutaneous BAP1-Inactivated Melanocytic Tumors: Results of a Multicenter Study by the International Dermoscopy Society

Dr. Julie Lamos presents findings from a multicenter study conducted by the International Dermoscopy Society on cutaneous BAP1-inactivated melanocytic tumors, known as papomas. These tumors resemble intradermal nevi or skin tags and are associated with mutations in the BAP1 tumor suppressor gene, increasing the risk of various cancers, including melanoma and mesothelioma, particularly when found in multiple instances. The objective was to identify unique dermoscopic features of these tumors, as they are often indistinguishable clinically. The study analyzed 48 papomas, half from patients with known BAP1 mutations. Five distinct dermoscopic patterns were identified: a structureless pink-tan variant with eccentric clots, a homogeneous pink region with radial vessels, and others. Notably, three patterns were more prevalent in syndromic cases, indicating a potential link to the mutation. Histological correlations confirmed that atypical cells were located in areas characterized by certain dermoscopic patterns. The findings suggest that while BAP1 papomas can present as benign lesions, recognizing these patterns through dermoscopy may aid in identifying patients at risk for internal malignancies and warranting further genetic testing.