Please use this identifier to cite or link to this item: doi:10.22028/D291-38929
Title: Etanercept leads to a rapid recovery of a Dabrafenib‐/Trametinib‐associated toxic epidermal necrolysis‐like severe skin reaction
Author(s): Yordanova, Krista
Pföhler, Claudia
Schweitzer, Luca F.
Bourg, Catherine
Adam, Leonie
Vogt, Thomas
Language: English
Title: Skin Health and Disease
Volume: 3 (2023)
Issue: 1
Publisher/Platform: Wiley
Year of Publication: 2022
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Targeted therapy with BRAF‐ and MEK‐Inhibitors (BRAFi, MEKi) provides an excellent therapeutic option for patients with malignant melanomas with a BRAF‐Mutation. Mild cutaneous adverse events have been common under the BRAF‐ and MEK‐Inhibitor therapy, on the contrary, severe cutaneous adverse reactions to drugs (SCARs) are rarely reported. We present the case of a 59‐ year‐old female patient who after the resection of cutaneous in‐transit metastases of a malignant melanoma received one adjuvant cycle of Nivolumab followed by a switch of the therapy to an oral BRAFi/MEKi therapy. 3–4 Weeks after the therapy switch she developed high fever, chills, progredient general weakness, headaches, abdominal complaints, generalised rash as well as thrombocytopaenia, eosinophilia, elevated liver enzymes, declining kidney, and pulmonary function as well as a maculopapular exanthema. She was diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS) and quickly started recovery after initiation of a high steroid substitution. Under steroid dose reduction, the exanthema worsened and toxic epidermal necrolysis (TEN) was histologically diagnosed. After a series of unsuccessful therapeutic approaches (high dose steroid, human immunoglobulins and ciclosporin) the patient received a single dose of the TNF‐alpha inhibitor etanercept, which led to a quick recovery. This case demonstrates that DRESS and TEN can present a spectrum of possibly transitioning SCARs providing a diagnostic and therapeutic challenge. Nevertheless, in a such complicated therapeutic setting, etanercept may be lifesaving even after multiple previous unsuccessful therapies. This effective approach provides evidence SCARs due to BRAF/MEK targeted therapy may be driven by TNF‐alpha.
DOI of the first publication: 10.1002/ski2.185
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-389294
ISSN: 2690-442X
Date of registration: 6-Feb-2023
Faculty: M - Medizinische Fakultät
Department: M - Dermatologie
Professorship: M - Prof. Dr. Thomas Vogt
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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