Abstract

CANTUDO-CUENCA, MR; SANCHEZ-ARGAIZ, MC; CANTUDO-CUENCA, MD  and  MORA-MORA, MA. Pustular psoriasis with BRAF inhibitors to treat metastatic melanoma. Rev. OFIL·ILAPHAR [online]. 2020, vol.30, n.1, pp.71-72.  Epub Jan 18, 2021. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2020000100018.

Targeted BRAF inhibition with vemurafenib and dabrafenib has proven to be a useful tool in the treatment of metastatic melanoma with BRAF-V600E mutation. While cutaneous adverse events are prevalent with BRAF inhibition, psoriasis is a rare complication. We report a case of palmoplantar pustular psoriasis in an adult man with metastatic melanoma treated with both BRAF inhibitors, sequentially. Systemic corticosteroids and apremilast were required to control symptomatology. To date, a case has been described in the literature of psoriasis associated with dabrafenib. We postulate that the elevation of tumor necrosis factor-alpha (TNF-a) and the paradoxical activation of the mitogen-activated protein kinase (MAPK) pathway due to BRAF inhibition may be responsible for this case. More studies are needed to further elucidate the immunopathogenic mechanisms behind this adverse event.

Keywords : BRAF kinases; melanoma; psoriasis; drug related side effects and adverse reactions.

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