BRAF inhibitors induce different types and grades of cutaneo | Figure 1

BRAF inhibitors induce different types and grades of cutaneous adverse events (AEs) that require prompt recognition and correct therapeutic management. Primary melanoma development, connected to the paradoxical activation of the mitogen-activated protein kinase pathway, is one of the reported AEs. Here we describe the unusual case of a 70-year-old woman affected by metastatic BRAF-mutated melanoma who developed, after 3 weeks of BRAF inhibitors therapy, a new subungual, blackish-brown, triangular-shaped, melanocytic lesion on the finger. The photographs were taken 4 weeks after the development of the lesion. Histology revealed an in situ melanoma. This is, to our knowledge, the first case of subungual second primary melanoma under BRAF inhibitor therapy.

Additional Cases

76 years old, male. Patient worked for many years as a rural worker exposed to the sun. He has a history of cancer in the family. This lesion appeared 5 months ago.

29-year-old male, developed lesions that raised concerns regarding potential nodular melanoma.

61M with a history of hemorrhoids and presenting symptoms consistent with possible mucosal melanoma.

“Melanoma” is a type of skin cancer, particularly noted in later stages due to its metastasis.

A 52-year-old man presented with symptoms of chest pain, dyspnea, and noted examination findings.

![A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. Notable findings made during examination.] (https://app.figure1.com/cdn-cgi/image/format=auto,quality=85,width=168,height=168,fit=cover,gravity=auto/https://figure1-pro-prod.imgix.net/cases/images/4b57fd3a0f2881e767006f6dcf6df71d56bef0dac2d7304e2162afc77f74ad11.png)

Physical examination revealed multiple lesions and pruritus in a 28-year-old female.

A 4-month-old male infant presented with skin lesions on the chin with surrounding inflammatory signs.

Patient in late teens presenting after a collapse, evaluation of EKG findings suggested.