Vemurafenib-induced eccrine squamous syringometaplasia

Area of Science:

• Dermatology
• Oncology

Background:

• Vemurafenib is a targeted therapy for metastatic melanoma with the V600E mutation.
• Cytostatic therapies are known to cause various cutaneous side effects.
• Eccrine squamous syringometaplasia (ESS) is a recognized adverse reaction to certain treatments.

Observation:

• A patient with stage IV melanoma treated with vemurafenib developed a characteristic skin eruption.
• The eruption presented as papules and vesicles, primarily in skin folds.
• Histological examination confirmed squamous metaplasia of the eccrine ductal epithelium, consistent with ESS.

Findings:

• Vemurafenib therapy was associated with the development of ESS in this patient.
• ESS is characterized by a symmetric cutaneous eruption with specific clinical and histological features.
• This case adds ESS to the spectrum of cutaneous adverse events linked to vemurafenib.

Implications:

• Clinicians should be aware of ESS as a potential side effect of vemurafenib in melanoma patients.
• Understanding the pathogenesis of vemurafenib-induced ESS is crucial for patient management.
• Differential diagnosis of skin eruptions in patients on vemurafenib should include ESS.