Gutzmer R, Hassel J C, Kähler K C, Loquai C, Mössner R, Ugurel S, Zimmer L, der das Ado Für Komitee Kutane Nebenwirkungen Ado
Klinik für Dermatologie, Allergologie und Venerologie, Hauttumorzentrum Hannover (HTZH), Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland,
Hautarzt. 2014 Jul;65(7):582-9. doi: 10.1007/s00105-013-2733-8.
BRAF and MEK inhibitors are new targeted therapies which are used in the treatment of malignancies, in particular of malignant melanoma.
Cutaneous side effects are common during the treatment with both types of inhibitors. These side effects include inflammatory reactions such as maculopapular and papulopustular exanthema, hand-foot syndrome, panniculitis, paronychia, photo- and radio-sensitization. As a class effect, BRAF-inhibitors induce proliferative disorders of keratinocytes and melanocytes, such as palmoplantar hyperkeratosis (as part of the hand-foot syndrome), verruciform and acanthoma-like lesions, follicular and Grover disease-like hyperkeratoses, keratoacanthomas, squamous cell carcinomas and atypical melanocytic nevi with transition to secondary melanomas. Furthermore, hair alterations and xerosis are possible.
Treatment with BRAF and MEK inhibitors requires close dermatologic monitoring of the patient. This manuscript summarizes the most frequent cutaneous side effects and their management.
BRAF和MEK抑制剂是用于治疗恶性肿瘤,特别是恶性黑色素瘤的新型靶向疗法。
在使用这两种抑制剂治疗期间,皮肤副作用很常见。这些副作用包括炎症反应,如斑丘疹和丘疹脓疱性皮疹、手足综合征、脂膜炎、甲沟炎、光致敏和放射致敏。作为一类效应,BRAF抑制剂可诱发角质形成细胞和黑素细胞的增殖性疾病,如掌跖角化过度(作为手足综合征的一部分)、疣状和棘皮瘤样病变、毛囊性和格罗弗病样角化过度、角化棘皮瘤、鳞状细胞癌以及向继发性黑色素瘤转变的非典型黑素细胞痣。此外,还可能出现毛发改变和皮肤干燥。
使用BRAF和MEK抑制剂治疗需要对患者进行密切的皮肤科监测。本文总结了最常见的皮肤副作用及其处理方法。