TY - JOUR
T1 - Histological features associated with vemurafenib-induced skin toxicities
T2 - Examination of 141 cutaneous lesions biopsied during therapy
AU - Curry, Jonathan L.
AU - Tetzlaff, Michael T.
AU - Nicholson, Kimberly
AU - Duvic, Madeleine
AU - Kim, Kevin B.
AU - Tsai, Kenneth Y.
AU - Hwu, Wen Jen
AU - Hong, David S.
AU - Prieto, Victor G.
AU - Torres-Cabala, Carlos A.
PY - 2014/7
Y1 - 2014/7
N2 - Dermatologic toxicities (DTs) associated with vemurafenib therapy include actinic keratosis (AK), verruca vulgaris (VV), keratoacanthoma (KA), and invasive squamous cell carcinoma (SCC), which may share histological features. The authors report the histological features to aid in distinguishing among these DTs. A 3-year retrospective examination of the authors' surgical pathology database was conducted and 141 cases of vemurafenib-associated DTs from 33 patients were identified. DTs were categorized into 3 groups: (1) cutaneous epithelial proliferations (CEP), (2) melanocytic lesions, and (3) inflammatory dermatoses. The authors compared the groups using analysis of variance, and P < 0.05 was considered significant. CEP (n = 120) accounted for 85% of all DTs biopsied. The most frequent diagnosis in the CEP category was VV (40%), followed by invasive SCC (24%) and AK (21%). KA was diagnosed in 3% of CEP. Histologically, AK, VV, KA, and invasive SCC may demonstrate similar morphological features in superficial sampled specimens. The mitotic rate was significantly higher in invasive SCC than other CEP (P < 0.003). The median tumor thickness of SCC was 2.60 mm. Evaluating the base of the keratinized lesion will aid in distinguishing the histological type of CEP and the management of the DTs; thus, a deep shave or punch biopsy may be warranted for patients who received vemurafenib therapy.
AB - Dermatologic toxicities (DTs) associated with vemurafenib therapy include actinic keratosis (AK), verruca vulgaris (VV), keratoacanthoma (KA), and invasive squamous cell carcinoma (SCC), which may share histological features. The authors report the histological features to aid in distinguishing among these DTs. A 3-year retrospective examination of the authors' surgical pathology database was conducted and 141 cases of vemurafenib-associated DTs from 33 patients were identified. DTs were categorized into 3 groups: (1) cutaneous epithelial proliferations (CEP), (2) melanocytic lesions, and (3) inflammatory dermatoses. The authors compared the groups using analysis of variance, and P < 0.05 was considered significant. CEP (n = 120) accounted for 85% of all DTs biopsied. The most frequent diagnosis in the CEP category was VV (40%), followed by invasive SCC (24%) and AK (21%). KA was diagnosed in 3% of CEP. Histologically, AK, VV, KA, and invasive SCC may demonstrate similar morphological features in superficial sampled specimens. The mitotic rate was significantly higher in invasive SCC than other CEP (P < 0.003). The median tumor thickness of SCC was 2.60 mm. Evaluating the base of the keratinized lesion will aid in distinguishing the histological type of CEP and the management of the DTs; thus, a deep shave or punch biopsy may be warranted for patients who received vemurafenib therapy.
KW - SCC
KW - dermatologic toxicities
KW - vemurafenib
UR - http://www.scopus.com/inward/record.url?scp=84903127400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903127400&partnerID=8YFLogxK
U2 - 10.1097/DAD.0000000000000018
DO - 10.1097/DAD.0000000000000018
M3 - Article
C2 - 24950418
AN - SCOPUS:84903127400
SN - 0193-1091
VL - 36
SP - 557
EP - 561
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 7
ER -