title: Pustular psoriasis eruption with dabrafenib, a BRAF inhibitor.
abstract: Targeted BRAF inhibition with vemurafenib and dabrafenib has dramatically improved the survival rate in metastatic melanoma. These agents are now being tested for their efficacy against other tumors with BRAF mutations, including lung adenocarcinoma. While cutaneous adverse events are prevalent with BRAF inhibition, our patient, to our knowledge, is the first to develop a psoriatic eruption with BRAF inhibitors. We postulate that the elevation of tumor necrosis factor-alpha (TNF-α) and the paradoxical activation of the mitogen-activated protein kinase (MAPK) pathway due to BRAF inhibition may be responsible for the eruption. More studies are needed to further elucidate the immunopathogenic mechanisms behind this adverse event. The response to MEK inhibitors and/or increased TNF-α inhibition may help support or debunk our hypothesis.
authors.affiliation: a Department of Dermatology , Baylor University Medical Center , Dallas , TX , USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Fawaz
authors.affiliation: a Department of Dermatology , Baylor University Medical Center , Dallas , TX , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Dickson
authors.affiliation: a Department of Dermatology , Baylor University Medical Center , Dallas , TX , USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008875:Middle Aged; D010091:Oximes / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D011565:Psoriasis / Q000139:chemically induced*
chemical_list: D000970:Antineoplastic Agents; D007093:Imidazoles; D010091:Oximes; D047428:Protein Kinase Inhibitors; D048493:Proto-Oncogene Proteins B-raf; C561627:dabrafenib
keywords: adverse; cutaneous; medication; reaction; toxicity