Neutrophilic Panniculitis Secondary to BRAF and MEK Inhibitor Therapy to Treat Stage IIIa Cutaneous Melanoma

IF 1.6 4区 医学 Q3 DERMATOLOGY
Tyra Reed, Steven Rivera, Craig Fisher, William Schaffenburg
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引用次数: 0

Abstract

Panniculitides are a group of inflammatory disorders of the subcutaneous fat that have been reported as a rare complication of both a serine threonine kinase BRAF inhibitor monotherapy and BRAF inhibition in combination with a mitogen activated protein kinase (MEK) inhibitor combination therapy used to treat metastatic melanoma. The cutaneous manifestations of BRAF and BRAF/MEK therapies have been well documented, but neutrophilic panniculitis remains a less common complication with fewer case reports. Physician awareness of this complication when following patients on similar targeted therapies can decrease delays in appropriate management. We report a case of one patient who developed neutrophilic panniculitis during treatment with the BRAF/MEK combination of dabrafenib and trametinib. We followed the patient from initial presentation in the emergency department to diagnosis to include pathology findings of the disease. In this case of neutrophilic panniculitis, the patient presented with a history of stage IIIa (pT2a N1a M0) cutaneous melanoma of the right flank and developed classic painful nodules on the lower legs and arms with associated fever within the first 2 weeks after initiating adjuvant melanoma targeted therapy. The biopsies showed a mixed, neutrophilic panniculitis, without overlying epidermal changes. Given the patient's clinical history, the biopsy was consistent with a BRAF inhibitor induced neutrophilic panniculitis. The panniculitis resolved with symptomatic care and the patient was maintained on the antitumor therapies.

BRAF继发中性粒细胞泛膜炎和MEK抑制剂治疗IIIa期皮肤黑色素瘤。
Panniculitides是一组皮下脂肪炎症性疾病,已被报道为丝氨酸苏氨酸激酶BRAF抑制剂单一治疗和BRAF抑制与丝裂原活化蛋白激酶(MEK)抑制剂联合治疗用于治疗转移性黑色素瘤的罕见并发症。BRAF和BRAF/MEK治疗的皮肤表现已经有很好的文献记载,但中性粒细胞泛膜炎仍然是一种不太常见的并发症,病例报告较少。医生在对病人进行类似的靶向治疗时意识到这种并发症可以减少适当管理的延误。我们报告了一例患者在BRAF/MEK联合使用达非尼和曲美替尼治疗期间发生中性粒细胞泛膜炎。我们跟踪患者从最初在急诊科的表现到诊断,包括疾病的病理结果。本例中性粒细胞全膜炎,患者出现右侧iii期(pT2a N1a M0)皮肤黑色素瘤病史,在开始黑色素瘤辅助靶向治疗后的前2周内,下肢和手臂出现典型的疼痛结节并伴有发热。活检显示混合性中性粒细胞泛膜炎,未见表皮改变。考虑到患者的临床病史,活检符合BRAF抑制剂引起的中性粒细胞全膜炎。经对症治疗后,全膜炎消失,患者继续接受抗肿瘤治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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