Year: 2014
Type: article
Study design: Case Report
Abstract: Cutis Verticis Gyrata in Association With Vemurafenib and Whole-Brain Radiotherapy Case Report 1A 33-year-old man presented to an outside hospital with a 2-month history of lower back pain, fever, chills, and anorexia.Physical examination revealed subcutaneous nodules on the chest, abdomen, and back.Cross-sectional imaging demonstrated multiple masses throughout the paraspinal tissue, vertebrae, liver, and subcutis.A magnetic resonance imaging scan of the brain showed four brain metastases ranging from 2 to 12 mm in size.An excisional biopsy of a subcutaneous lesion revealed metastatic melanoma characterized by a BRAF V600E mutation.The patient initiated external-beam whole-brain radiotherapy (WBRT, 30 Gy over 10 daily fractions with 6 MV photons) and vemurafenib at a dose of 960 mg orally twice per day.After seven of 10 fractions of WBRT (21 Gy), the patient developed pain and erythema of the ears and scalp, resulting in a diagnosis of grade 2 radiation dermatitis.The patient temporarily stopped WBRT and received topical emollients.Vemurafenib was continued without a dose reduction.After slight improvement in his symptoms, WBRT was reinitiated to complete the 10 fractions.The patient subsequently noted recurrence and worsening of his symptoms, which reached their maximum severity approximately 3 weeks after completion of WBRT.Photographs (Figs 1A and 1B) of his head and neck demonstrate a severe confluent erythematous and hyperkeratotic plaque limited to the radiation field.Tortuous skin folding
Source: Journal of Clinical Oncology
Institution: Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: National Cancer Institute
OpenAlex ID: W2099356406