[Acantholytic dermatosis in patients treated by vemurafenib: 2 cases]

Ann Dermatol Venereol. 2014 Nov;141(11):689-93. doi: 10.1016/j.annder.2014.09.024. Epub 2014 Oct 23.
[Article in French]

Abstract

Background: Acantholytic dyskeratosis under BRAF inhibitors are dermatological diseases rarely reported to date.

Patients and methods: We report 2 cases of acantholytic dyskeratosis, reaching the trunk and the seborrheic zones, not itchy, appeared one month after the introduction of vemurafenib. The histological analysis was typical of a "Grover-like rash" for the 2 patients.

Discussion: The appearance of acantholytic dyskeratosis under vemurafenib, a BRAF inhibitor, seems related with a paradoxical activation of the MAP-kinases pathway and with a growth acceleration of lesions in which RAS mutations of keratinocytes. Theses dermatoses seem also to occur with dabrafenib.

Conclusion: The patients treated by BRAF inhibitors (vemurafenib and dabrafenib) can present acantholytic dyskeratosis. The arisen of this mild dermatosis does not question, of course, the continuation of the treatment. These cutaneous manifestations can be managed with emollients.

Keywords: Acantholytic dyskeratosis; Dermatose acantholytique; Drug adverse effects; Effets secondaires des médicaments; Grover; Melanoma; Mélanome; Vemurafenib; Vémurafénib.

Publication types

  • Case Reports

MeSH terms

  • Acantholysis / chemically induced*
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Drug Eruptions / etiology*
  • Exanthema / chemically induced
  • Female
  • Humans
  • Ichthyosis / chemically induced*
  • Imidazoles / adverse effects
  • Indoles / adverse effects*
  • MAP Kinase Signaling System / drug effects
  • Male
  • Melanoma / drug therapy
  • Melanoma / genetics
  • Melanoma / secondary
  • Middle Aged
  • Mutation / drug effects
  • Mutation / genetics
  • Oximes / adverse effects
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Proto-Oncogene Proteins B-raf / genetics
  • Sulfonamides / adverse effects*
  • Vemurafenib
  • ras Proteins / drug effects
  • ras Proteins / genetics

Substances

  • Antineoplastic Agents
  • Imidazoles
  • Indoles
  • Oximes
  • Sulfonamides
  • Vemurafenib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • ras Proteins
  • dabrafenib

Supplementary concepts

  • Grover's disease