Sibaud V, Lamant L, Maisongrosse V, Delord J-P
Service de dermatologie, unité phases cliniques précoces, centre de lutte contre le cancer, institut Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse, France.
Ann Dermatol Venereol. 2013 Aug-Sep;140(8-9):510-20. doi: 10.1016/j.annder.2013.02.031. Epub 2013 Jun 19.
Recent developments and therapeutic use of selective BRAF inhibitors (e.g. dabrafenib and vemurafenib) have significantly improved overall survival and disease-free survival of patients with BRAF V600 mutation-positive metastatic melanoma. Despite their survival benefits, small-molecule inhibitors of BRAF are associated with significant and sometimes severe treatment-related dermatological toxicity. The most common adverse skin reactions include photosensitivity, induced malignant lesions of the skin such as keratoacanthomas, squamous cell carcinoma and new primary melanomas, as well as keratinocyte proliferation and differentiation dysfunctions that can manifest as skin papillomas, hand-foot skin reaction, keratosis pilaris-like rash, acantholytic dyskeratosis and cysts of the milia type. In this article, we describe the clinical and histological features of the cutaneous manifestations induced by vemurafenib and dabrafenib on the basis of our clinical experience and a literature review. The crucial role of dermatologists in patient management is also highlighted.
选择性BRAF抑制剂（如达拉非尼和维莫非尼）的最新进展及治疗应用显著提高了BRAF V600突变阳性转移性黑色素瘤患者的总生存期和无病生存期。尽管它们具有生存获益，但BRAF小分子抑制剂与显著的、有时甚至是严重的治疗相关皮肤毒性有关。最常见的皮肤不良反应包括光敏性、诱发的皮肤恶性病变，如角化棘皮瘤、鳞状细胞癌和新发原发性黑色素瘤，以及角质形成细胞增殖和分化功能障碍，可表现为皮肤乳头状瘤、手足皮肤反应、毛发角化病样皮疹、棘层松解性角化不良和粟丘疹样囊肿。在本文中，我们根据临床经验和文献综述描述了维莫非尼和达拉非尼诱发的皮肤表现的临床和组织学特征。还强调了皮肤科医生在患者管理中的关键作用。
