title: Photodynamic therapy for multiple eruptive keratoacanthomas associated with vemurafenib treatment for metastatic melanoma.
abstract: BACKGROUND
  The development of keratoacanthomas (KAs) and well-differentiated squamous cell carcinomas (SCCs) is a known adverse effect of novel BRAF inhibitors such as vemurafenib. With multiple such neoplasms often arising after BRAF inhibitor therapy, surgical excision is often impractical.
  
  
  METHODS
  We describe a patient with stage IV melanoma who received the BRAF inhibitor vemurafenib (recently approved by the US Food and Drug Administration) as part of a clinical trial and developed numerous diffuse, pathology-proven KAs and SCCs. The high number of lesions across a broad area precluded surgical treatment; instead, a noninvasive field approach using photodynamic therapy (PDT) was initiated. Compared with untreated tumors, most lesions demonstrated significant clinical regression following successive cycles of PDT.
  
  
  CONCLUSIONS
  Given vemurafenib's recent approval by the US Food and Drug Administration, we provide a timely case report on the effective use of PDT in the treatment of BRAF inhibitor-associated KAs and SCCs. Although further studies are needed to better understand the biological processes of these secondary neoplasms, our observation provides an alternative noninvasive solution for improving the quality of life for patients receiving BRAF inhibitor therapy.
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Allireza
authors.initials: A
authors.lastname: Alloo
authors.forename: Lilit
authors.initials: L
authors.lastname: Garibyan
authors.forename: Nicole
authors.initials: N
authors.lastname: LeBoeuf
authors.forename: George
authors.initials: G
authors.lastname: Lin
authors.forename: Andrew
authors.initials: A
authors.lastname: Werchniak
authors.forename: F Stephen
authors.initials: FS
authors.lastname: Hodi
authors.forename: Keith T
authors.initials: KT
authors.lastname: Flaherty
authors.forename: Donald P
authors.initials: DP
authors.lastname: Lawrence
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lin
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000188:drug therapy; D018450:Disease Progression; D003875:Drug Eruptions / Q000188:drug therapy*; D006801:Humans; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D007636:Keratoacanthoma / Q000139:chemically induced* / Q000188:drug therapy*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000139:chemically induced / Q000188:drug therapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D000077484:Vemurafenib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D017319:Photosensitizing Agents; D013449:Sulfonamides; D000077484:Vemurafenib; D000622:Aminolevulinic Acid