Acantholytic dermatosis in patients treated by vemurafenib: 2 cases

• Published in: Annales de dermatologie et de vénéréologie 2014-11, Vol.141 (11), p.689-693
• Main Authors: Sabatier-Vincent, M, Charles, J, Pinel, N, Challende, I, Claeys, A, Leccia, M-T
• Format: Article
• Language: fre
• Subjects: Acantholysis - chemically induced; Aged; Antineoplastic Agents - adverse effects; Drug Eruptions - etiology; Exanthema - chemically induced; Female; Humans; Ichthyosis - chemically induced; Imidazoles - adverse effects; Indoles - adverse effects; Male; MAP Kinase Signaling System - drug effects; Melanoma - drug therapy; Melanoma - genetics; Melanoma - secondary; Middle Aged; Mutation - drug effects; Mutation - genetics; Oximes - adverse effects; Proto-Oncogene Proteins B-raf - antagonists & inhibitors; Proto-Oncogene Proteins B-raf - genetics; ras Proteins - drug effects; ras Proteins - genetics; Sulfonamides - adverse effects
• ISSN: 0151-9638
• DOI: 10.1016/j.annder.2014.09.024

Acantholytic dyskeratosis under BRAF inhibitors are dermatological diseases rarely reported to date. We report 2 cases of acantholytic dyskeratosis, reaching the trunk and the seborrheic zones, not itchy, appeared one month after the introduction of vemurafenib. The histological analysis was typical of a "Grover-like rash" for the 2 patients. The appearance of acantholytic dyskeratosis under vemurafenib, a BRAF inhibitor, seems related with a paradoxical activation of the MAP-kinases pathway and with a growth acceleration of lesions in which RAS mutations of keratinocytes. Theses dermatoses seem also to occur with dabrafenib. The patients treated by BRAF inhibitors (vemurafenib and dabrafenib) can present acantholytic dyskeratosis. The arisen of this mild dermatosis does not question, of course, the continuation of the treatment. These cutaneous manifestations can be managed with emollients.