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Fig 1.

Tumor tissues with hematoxylin-eosin staining and with immunohistochemistry reaction for anti-VE1 antibody.

(A) Histopathological features of in situ superficial spreading melanoma, exhibiting mainly scattered melanocytes along the basal layer and only few pagetoid cells spreading in the epidermis (H&E staining, original magnification 400x) (B) BRAF V600E IHC negative case characterized by complete lack of tumor cell immunostaining (original magnification 400x)—A and B corresponding to the case in Fig 2 (2A). (C) Histopathological features of superficial spreading melanoma, 1 mm in Breslow thickness showing a predominantly nested pattern of large intraepidermal and junctional nests (arrows) (H&E staining, original magnification 400x). (D) BRAF V600E cytoplasmic immunostaining positive (original magnification 200x)—C and D corresponding to the case in Fig 2D.

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Table 1.

Clinical variables and BRAF V600E mutation.

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Table 2.

Histological variables and BRAF V600E mutation.

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Table 3.

Confocal microscopy characteristics and BRAF V600E mutation.

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Fig 2.

Comparison between findings of dermatoscopy and RCM.

(A) Dermoscopy of BRAF V600E negative in situ superficial spreading melanoma: broadened pigmented network (the inset corresponds to clinical image). (B) RCM mosaic image (1.5x1.5 mm) in DEJ shows junctional thickening due to isolated atypical cells (yellow arrows). (C) RCM mosaic image (1.5x1.5 mm) in DEJ showing non-edged papillae separated by loosely thick interpapillary spaces (yellow arrows) and meshwork pattern (red arrows). (D) Dermoscopy of BRAF V600E mutated superficial spreading melanoma, 1 mm in Breslow thickness): multicomponent pattern (the inset corresponds to clinical image). (E) RCM mosaic image (0.75x0.75 mm) at the level of the epidermis shows hyporeflective pagetoid cells (red arrows) and epidermal nests (yellow arrow). (F) RCM mosaic image (0.75x0.75 mm) at the level of the DEJ shows dermal-epidermal nests (yellow arrows).

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Fig 3.

Graphic age x BRAF V600E.

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Table 4.

Clinical and histological characteristics of BRAF V600E mutated melanomas.

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Table 5.

Multivariate analysis for the identification of independent predictive factors for positive BRAF V600E.

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Table 6.

Distribution of cases according to BRAF V600E status and number of cumulative predictive factors.

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Fig 4.

ROC curve of positivity for BRAF V600E.

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Table 7.

Clinical, dermoscopic, confocal microscopy and histopathological features of positive and negative BRAF V600E melanomas.

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