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BRAF Inhibitor-Associated Granulomatous Dermatitis: A Report of 3 Cases

Eugene Liat Hui Ong1, Rishika Sinha2, Shilan Jmor3

  • 1Dermatology Department, Chelsea Westminster Hospital, London, United Kingdom.

The American Journal of Dermatopathology
|January 3, 2019
PubMed

Insights

Granulomatous dermatitis is a rare side effect of vemurafenib, a BRAF inhibitor used for metastatic melanoma. This skin condition resolved quickly after stopping vemurafenib treatment.

Area of Science:

  • Dermatology
  • Oncology
  • Pharmacology

Background:

  • BRAF inhibitors are a targeted therapy for metastatic melanoma.
  • Cutaneous toxicities are common with BRAF inhibitor treatment.
  • Granulomatous dermatitis is a rare but distinct adverse reaction.

Observation:

  • Three patients with metastatic melanoma developed asymptomatic papular eruptions.
  • The eruptions appeared 8-21 months after initiating vemurafenib therapy.
  • Skin biopsies confirmed granulomatous dermatitis, excluding other causes.

Findings:

  • Granulomatous dermatitis associated with vemurafenib can occur late in treatment.
  • Topical and oral steroids provided partial improvement.
  • Complete resolution of skin lesions occurred within two weeks of discontinuing vemurafenib.

Implications:

  • Clinicians should consider granulomatous dermatitis in patients on long-term vemurafenib.
  • This specific toxicity may allow for continued BRAF inhibitor therapy after resolution.
  • Early recognition and management can improve patient quality of life during melanoma treatment.

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