Tyra Reed, Steven Rivera, Craig Fisher, William Schaffenburg
{"title":"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。","authors":"Tyra Reed, Steven Rivera, Craig Fisher, William Schaffenburg","doi":"10.1111/cup.14778","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>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.</p>\n </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"52 4","pages":"278-283"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neutrophilic Panniculitis Secondary to BRAF and MEK Inhibitor Therapy to Treat Stage IIIa Cutaneous Melanoma\",\"authors\":\"Tyra Reed, Steven Rivera, Craig Fisher, William Schaffenburg\",\"doi\":\"10.1111/cup.14778\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>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.</p>\\n </div>\",\"PeriodicalId\":15407,\"journal\":{\"name\":\"Journal of Cutaneous Pathology\",\"volume\":\"52 4\",\"pages\":\"278-283\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-01-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cutaneous Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cup.14778\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cutaneous Pathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cup.14778","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Neutrophilic Panniculitis Secondary to BRAF and MEK Inhibitor Therapy to Treat Stage IIIa Cutaneous Melanoma
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.
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.