title: MEK inhibitor-induced dusky erythema: characteristic drug hypersensitivity manifestation in 3 patients.
abstract: OBJECTIVE
  MEK inhibitors are being evaluated in clinical trials for treatment of different malignant neoplasms; trametinib dimethyl sulfoxide was approved by the US Food and Drug Administration for melanoma in 2013. We present 3 cases of patients receiving MEK inhibitors who developed an atypical eruption.
  
  
  METHODS
  Three patients who were receiving different MEK inhibitors (selumetinib, cobimetinib, and trametinib) developed an eruption, all associated with unique duskiness. Drug hypersensitivity was confirmed by histopathologic testing in 2 of the 3 cases. The skin eruption responded well to corticosteroids and did not recur when treatment with the MEK inhibitor was restarted in 2 of the patients.
  
  
  CONCLUSIONS
  The typical skin reaction associated with MEK inhibitors is a papulopustular eruption. To our knowledge, the dusky erythema that occurred in the 3 patients described here has not previously been reported for this drug class.
authors.affiliation: Division of Dermatology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Urvi
authors.initials: U
authors.lastname: Patel
authors.affiliation: Division of Dermatology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Lynn
authors.initials: L
authors.lastname: Cornelius
authors.affiliation: Division of Dermatology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Milan J
authors.initials: MJ
authors.lastname: Anadkat
mesh_terms: D000328:Adult; D001384:Azetidines / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001562:Benzimidazoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D004890:Erythema / Q000139:chemically induced / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy; D008875:Middle Aged; D020929:Mitogen-Activated Protein Kinase Kinases / Q000037:antagonists & inhibitors; D010880:Piperidines / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D011728:Pyridones / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D011744:Pyrimidinones / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy
chemical_list: C517975:AZD 6244; D001384:Azetidines; D001562:Benzimidazoles; D005938:Glucocorticoids; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011728:Pyridones; D011744:Pyrimidinones; C560077:trametinib; D020929:Mitogen-Activated Protein Kinase Kinases; C574276:cobimetinib