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Human papillomavirus-negative epithelial proliferations resembling condylomata acuminata in a patient receiving vemurafenib for Stage IV melanoma


1 Department of Dermatology, Netherlands Cancer Institute, Amsterdam; Department of Dermatology, MC Zuiderzee Hospital, Lelystad, Netherlands
2 Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
3 Department of Dermatology, Netherlands Cancer Institute, Amsterdam, Netherlands

Correspondence Address:
Marnix H Geukes Foppen,
Department of Medical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam
Netherlands
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_317_17

With the discovery of v-Raf murine sarcoma viral oncogene homolog B (BRAF) inhibitors, new treatment possibilities arose against metastatic melanoma. A frequent adverse effect of BRAF inhibitor therapy is the induction of epithelial proliferations such as cutaneous squamous cell carcinoma and verrucous papilloma. Here, we describe a case in which a patient developed extensive anal epithelial proliferations resembling condylomata acuminata, after starting vemurafenib treatment. This adverse effect has rarely been reported in the literature. Interestingly, the lesions in our patient were negative for human papillomavirus, and mutations in BRAF, Neuroblastoma rat sarcoma viral oncogene homolog (NRAS), Kirsten rat sarcoma viral oncogene homolog (KRAS), and Harvey rat sarcoma viral oncogene homolog (HRAS) were not detected. Different pathways can contribute to these epithelial proliferations resembling condylomata acuminata. We show the relevance of a detailed history at the beginning and during treatment, instructions, education, and dermatological follow-up (including the genital area) for patients treated with BRAF inhibitors. Condylomata acuminata can influence the quality of life and are treated, in an early stage, with cryotherapy, coagulation, imiquimod, and/or CO2 laser therapy.


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    -  Peters MA
    -  Geukes Foppen MH
    -  Blank CU
    -  Crijns MB
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