Persistent granulomatous cutaneous drug eruption to a BRAF inhibitor

Targeted BRAF-inhibitors (BRAF-I) are exciting new therapeutic options for patients with metastatic melanoma. Cutaneous toxicity from BRAF-I is widely reported and poses a management challenge. We present a rare manifestation of persistent cutaneous toxicity to a BRAF-I. A 41-year-old female had a pT2b melanoma (Breslow 1.01mm) excised from her right thigh. BRAF V600E mutation was detected. Sentinel lymph node biopsy was positive so she underwent femoral/ilioinguinal lymph node dissection. Staging CT scan showed subcarinal lymphadenopathy and small pulmonary metastasis.

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