Panniculitis in Patients Treated With BRAF Inhibitors
- 1 June 2014
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Dermatopathology
- Vol. 36 (6), 493-497
- https://doi.org/10.1097/dad.0000000000000023
Abstract
Panniculitis is a rare complication of BRAF inhibitor therapy that is used to treat patients with BRAF-mutated metastatic melanoma. We present a clinicopathologic review of 9 patients who developed panniculitis while on BRAF inhibitor therapy. In 13% of patients on vemurafenib, 3% of patients on dabrafenib and 10% on combination of dabrafenib + trametinib, tender erythematous nodular lesions of panniculitis appeared on legs, arms and trunk. Histological evaluation of 8 biopsies from 7 patients showed predominantly neutrophilic infiltrate in 4, lymphocytic in 1, and mixed in 3. Lesions with neutrophilic infiltrate appeared in earlier stages of treatment than those with mixed or lymphocytic infiltrate. All biopsies showed lobular involvement and 5 also had a septal component. In addition, 1 biopsy had lichenoid inflammation in the epidermis and the other had evidence of vasculitis. Most patients responded to conservative medical management without the need to reduce or to stop BRAF inhibitor therapy. Panniculitis seems to be a rare class effect of BRAF inhibitors that is predominantly lobular and neutrophilic, although other patterns can be seen.Keywords
This publication has 19 references indexed in Scilit:
- Neutrophilic panniculitis developing after treatment of metastatic melanoma with vemurafenibJournal of Cutaneous Pathology, 2013
- Cutaneous effects of BRAF inhibitor therapy: a case seriesAnnals of Oncology, 2013
- Vemurafenib-induced neutrophilic panniculitisMelanoma Research, 2012
- Dynamic Changes in Nevi of a Patient With Melanoma Treated With VemurafenibArchives of Dermatology, 2012
- Cutaneous manifestations of dabrafenib (GSK2118436): a selective inhibitor of mutant BRAF in patients with metastatic melanomaBritish Journal of Dermatology, 2012
- Atypical Melanocytic Proliferations and New Primary Melanomas in Patients With Advanced Melanoma Undergoing Selective BRAF InhibitionJournal of Clinical Oncology, 2012
- Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trialThe Lancet, 2012
- Cutaneous side effects (cAE) of vemurafenib (V): Single-center cohort study of 28 metastatic melanoma (mM) patients (pts).Journal of Clinical Oncology, 2012
- Panniculitis With Arthralgia in Patients With Melanoma Treated With Selective BRAF Inhibitors and Its ManagementArchives of Dermatology, 2012
- Improved Survival with Vemurafenib in Melanoma with BRAF V600E MutationThe New England Journal of Medicine, 2011