title: Sequential monitoring of pigmented lesions during dabrafenib treatment: a prospective study and a literature overview.
abstract: BACKGROUND
  Targeted therapies in melanoma have shown clinical benefit in incrementing the overall survival of metastatic patients. However, cutaneous adverse events have been frequently associated with these drugs.
  
  
  METHODS
  We report our experience in the management of patients treated with dabrafenib for metastatic melanoma, focusing on the monitoring of pigmented lesions. Dermatologic evaluation was performed during the first visit, at the start of each treatment and subsequently after every four weeks. Global nevi count, videodermoscopy of suspected lesions, and surgical excisions when necessary were performed at the beginning of the treatment and every fourth week. All other cutaneous adverse events (cAEs) were noted and documented. Eleven patients were included.
  
  
  RESULTS
  The most important cAEs included palmo-plantar hyperkeratosis, diffuse xerosis and pigmented lesion changes. Regarding the latter, in 6 patients, especially in the first months of treatment, we observed hyperpigmentation and hyperkeratosis of the nevi, of the pigmented mucosae and, in one patient, hyperkeratotic changes on a cutaneous metastasis. Histopathology of the excised lesions showed one ex novo melanoma occurrence and benign changes to pre-existing nevi.
  
  
  CONCLUSIONS
  The awareness of the importance of sequential monitoring of pigmented lesions, with particular attention to the lesions of new onset, is crucial for the best management of these complex patients.
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Emi
authors.initials: E
authors.lastname: Dika
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy - mlambertini@hotmail.it.
authors.forename: Martina
authors.initials: M
authors.lastname: Lambertini
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Pier A
authors.initials: PA
authors.lastname: Fanti
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Piraccini
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Gurioli
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Giulia M
authors.initials: GM
authors.lastname: Ravaioli
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Chessa
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Traniello Gradassi
authors.affiliation: Unit of Medical Oncology, Sant'Orsola Malpighi Hospital Bologna, Bologna, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Melotti
authors.affiliation: Unit of Medical Oncology, Sant'Orsola Malpighi Hospital Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Sperandi
authors.affiliation: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D009508:Nevus, Pigmented / Q000139:chemically induced; D010091:Oximes / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D007093:Imidazoles; D010091:Oximes; C561627:dabrafenib