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Cutaneous Complications of Targeted Melanoma Therapy

  • Emily de Golian
  • Bernice Y. Kwong
  • Susan M. Swetter
  • Silvina B. Pugliese
Skin Cancer (BY Kwong, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Skin Cancer

Opinion statement

The landscape of advanced and metastatic melanoma therapy has shifted dramatically in recent years. Since 2011, eight drugs (ipilimumab, vemurafenib, dabrafenib, trametinib, cometinib, pembrolizumab, nivolumab, and talimogene laherparepvec) have received FDA approval for the treatment of advanced or metastatic melanoma, including combination regimens of both small molecule kinase and immune checkpoint inhibitors. These therapies have revolutionized the management of unresectable regional nodal and distant melanoma, providing hope of extended survival to patients. As the use of novel agents has increased, so have the cutaneous toxicities associated with these medications. While most skin reactions are low-grade and can be managed conservatively with topical therapies, malignant lesions and more serious or life-threatening drug reactions can arise during therapy, requiring prompt dermatologic recognition and treatment in order to improve patient outcome. Given the survival benefit attributed to these new agents, treating skin toxicity and maintaining patient quality of life is of paramount importance. Oncologists should be aware of the common cutaneous toxicities associated with these medications and should be encouraged to involve dermatologists in the collaborative care of advanced melanoma patients. Close communication between oncologists and dermatologists can help to avoid unnecessary dose reduction or treatment discontinuation and identify situations when treatment cessation is truly warranted.

Keywords

Supportive dermato-oncology Oncodermatology Ipilimumab Vemurafenib Dabrafenib Trametinib Cometinib Pembrolizumab Nivolumab BRAF inhibitor MEK inhibitor CTLA-4 antibody PD-1 antibody Checkpoint inhibitors Morbilliform rash Verrucal keratoses Keratoacanthoma Squamous cell carcinoma Vitiligo Autoimmune dermopathy Lichenoid dermatitis Photosensitivity Hand foot skin reaction Papulopustular eruption Pruritus Xerosis 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Emily de Golian
    • 1
  • Bernice Y. Kwong
    • 1
  • Susan M. Swetter
    • 1
    • 2
  • Silvina B. Pugliese
    • 1
  1. 1.Department of Dermatology, Cutaneous OncologyStanford University Medical Center and Cancer InstitutePalo AltoUSA
  2. 2.Dermatology ServiceVeterans Affairs Palo Alto Health Care SystemPalo AltoUSA

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