Artículo de revista
Panniculitis in association with target therapy in melanoma patient, what the dermatologist should know: A case report
Fecha
2020Registro en:
Medwave Volumen: 20 Número: 7 Aug 2020
10.5867/medwave.2020.07.8010
Autor
Manubens Vargas, Víctor
Rodríguez Ortubia, Manuel
Salas, Jose
Valenzuela, Fernando
Carreño Toro, Laura
Institución
Resumen
Target therapies are currently a therapeutic option increasingly used for the management of patients with
metastatic melanoma. However, there are multiple adverse pharmacological effects associated with their
use that have been described. Cutaneous adverse reactions are the most frequent. We report the case of a
55-year-old man with a diagnosis of stage IV BRAFV600E-mutated metastatic cutaneous melanoma
undergoing treatment with dabrafenib/trametinib, who consulted due to the development of
erythematous nodular lesions in the upper and lower limbs associated with febrile sensation during the
course of treatment. Infection was ruled out and a biopsy of the skin lesions was done, which provided
the histopathological confirmation of a predominantly septal, granulomatous with leukocytoclastic
vasculitis, mixed panniculitis. Panniculitis associated with this therapy has been described in the
literature and has been considered an immune-mediated pharmacological adverse effect. It is considered
to be related to a better prognosis in the treatment of metastatic melanoma. Consequently, as shown in
this case report, target therapy should not be discontinued and symptomatic medication should be given
to alleviate patient discomfort. The dermatologist should know and properly interpret this adverse effect
and prescribe the most appropriate management for the patient.