Case report observes systemic sarcoid-like reactions during BRAF and MEK inhibitor treatment for metastatic melanoma, highlighting rare immune toxicities during targeted therapy.
Key Points
To document a rare clinical presentation of systemic drug-induced sarcoid-like reactions occurring during prolonged targeted combination therapy for metastatic melanoma.
Clinical, histological, and radiological assessment of a patient with metastatic melanoma treated with dabrafenib (150 mg twice daily) and trametinib (2 mg once daily).
Longitudinal monitoring, including skin biopsies at 3 years and 4 months and follow-up histological sampling of lungs and mediastinal lymph nodes at 1 year post-cutaneous onset.
Cutaneous eruptions morphologically identified as sarcoid-like granulomas developed on the upper extremities and trunk after 40 months of continuous targeted therapy.
Follow-up examination at 1 year revealed systemic dissemination, with histologically confirmed non-caseating sarcoid-like granulomas within pulmonary parenchyma and mediastinal lymph nodes.
Dabrafenib and trametinib therapy was maintained without interruption alongside topical corticosteroid application under ongoing multidisciplinary specialist care.