title: Painful nipple hyperkeratosis secondary to vemurafenib.
abstract: Vemurafenib is a selected BRAF kinase inhibitor approved for treating metastatic or unresectable melanoma, which has numerous cutaneous side effects unfortunately, including three previously reported cases of asymptomatic areola and/or nipple hyperkeratosis. We present the first case of painful bilateral nipple hyperkeratosis secondary to vemurafenib in an 84-year-old woman. She was successfully treated with tretinoin 0.05% cream that allowed her to comfortably continue treatment. With increased awareness of this condition, we found a second case of asymptomatic nipple hyperkeratosis secondary to vemurafenib in our clinic. As this medication gains acceptance for treatment of metastatic melanoma, it is imperative that dermatologists are aware of this potentially uncomfortable side effect that can result in decreased compliance and impaired quality of life.
authors.affiliation: Department of Dermatology, Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple, Texas, 76508.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Carr
authors.affiliation: Department of Dermatology, Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple, Texas, 76508.
authors.forename: Shannon C
authors.initials: SC
authors.lastname: Brown
authors.affiliation: Department of Dermatology, Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple, Texas, 76508.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Fiala
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D007642:Keratosis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D008545:Melanoma / Q000188:drug therapy; D009558:Nipples / Q000473:pathology*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D011788:Quality of Life; D012878:Skin Neoplasms / Q000188:drug therapy; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects*; D014212:Tretinoin / Q000008:administration & dosage; D000077484:Vemurafenib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D047428:Protein Kinase Inhibitors; D013449:Sulfonamides; D000077484:Vemurafenib; D014212:Tretinoin; D048493:Proto-Oncogene Proteins B-raf
keywords: hyperkeratosis; painful nipple; vemurafenib