Cumulative dermatologic toxicity with ipilimumab and vemurafenib responsive to corticosteroids

Dermatologic toxicity is a known reaction of ipilimumab and vemurafenib. Because of the lack of effective treatments and aggressive nature of melanoma, treatments are often discontinued and new treatments are initiated in rapid succession. We report what we believe to be the first case of cumulative dermatologic toxicity secondary to rapid-sequential treatment with ipilimumab and vemurafenib for metastatic melanoma that responded to high-dose steroids. This case highlights the combined toxicity of these two drugs that can occur as a result of overlapping toxicity. It also illustrates the need for a substantial wash out period between rapid cycling of these two drugs secondary to ipilimumab's long half-life.