Eruptive milia secondary to vemurafenib

Multiple milia formation induced by dovitinib

Dovitinib is a novel multi-target tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor-1-3, platelet-derived growth factor receptor-β, Fms-like tyrosine kinase 3, c-Kit and fibroblast growth factor receptor-1-3. This compound is currently being assessed clinically for treatment of various malignancies. In phase I and II clinical trials of dovitinib treatment for renal cell carcinoma, 20% of patients experienced cutaneous adverse events, although the specific type of skin rash was not documented. Here, we report two cases of multiple milia formation induced by dovitinib. We believe our cases are the first report mainly showing non-inflammatory cystic structure.

Managing the skin toxicities from new melanoma drugs

Patients treated with ipilimumab or targeted inhibitors of the RAF-MEK-ERK pathway (vemurafenib, dabrafenib, and trametinib) for advanced cutaneous melanoma often experience drug-related skin toxicities denoted as dermatologic adverse events (DAEs). Although rarely life-threatening, DAEs may emerge dramatically and potentially compromise oncologic therapy if not managed in a timely and effective manner. Early recognition of DAEs is critical to providing optimal skin care and prompt consultation with a dermatologist should be obtained when a diagnosis is unclear. The expanding utilization of new melanoma drugs compels physicians to maintain a watchful eye for both known and novel DAEs and to adopt a low threshold to biopsy worrisome skin findings. Numerous therapeutic options are available to manage DAEs including topical and systemic agents as well as surgical and destructive modalities. Applying such methods improves overall patient care and optimizes the effectiveness of new therapies for advanced cutaneous melanoma.