The BRAAFF index practical application in the diagnosis of acral melanocytic tumors

January 21, 2021

Melanoma is one of the most dangerous tumors due to its ability to rapidly unpredictable metastasis. When the tumor is in open areas, the possibility of timely diagnosis increases, and with acral localization, melanoma for a long time may be neglected. To improve the prognosis of patients with acral melanoma, it is a prerequisite to ensure early diagnosis, which is the method of dermatoscopy. The role in the diagnosis of acral located pigmentation is to assess the features of the structure, which, unlike nevi of other localizations, is most often manifested in the form of patterns of parallel furrows, fibers, lattice-like pattern, and parallel ridge pattern. However, about 1⁄₃ of acral melanomas may consist of irregular diffuse pigments and other components, so additional criteria would be needed to reduce the likelihood of diagnostic errors. The result was the development, by a team of scientists from around the world, of the BRAAFF index, which is a score system for six variables that demonstrated the highest sensitivity and specificity for acral melanoma. Predictors such as irregular spotting, parallel ridge pattern, asymmetry of structures and colors give positive points, whereas parallel furrow and fibrillar pattern is negative. A diagnosis of acral melanoma is considered probable if the result of the calculations is ≥1. Use of the BRAAFF index can greatly improve the quality and specificity of the examination when used in daily practice. It will also be useful for doctors who are just starting their careers and do not have sufficient experience to confidently prescribe therapeutic tactics. The publication provides clinical example of the use of an algorithmic approach for the management of patient with acral lesions on the skin.


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