Trametinib
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Acneiform eruption following off-label use: 3 case reports In a case report, three patients (one girl and two boys) aged 13–16 years were described, who developed acneiform eruptions following off-label therapy with trametinib for neurofibromatosis type I [route and dosage not stated]. A 16-year-old girl, who had neurofibromatosis type I and a voluminous plexiform neurofibroma on the right thigh, started receiving off-label trametinib. After 2 weeks, she presented with a dramatic monomorphic papulopustular eruption on her chin, nose and forehead. Therefore, she initiated therapy with doxycycline. At follow-up after 6 weeks, a marked improvement was observed. However, 4 weeks later, a recurrence of skin lesions was noticed. Therefore, she was started on isotretinoin therapy. After 3 months, a significant clearing of lesions was noted. She continued therapy with isotretinoin for 1 year, as it was well tolerated. A 16-year-old boy, who had neurofibromatosis type I and unresectable painful right paravertebral plexiform neurofibroma, started receiving off-label trametinib. After 4 weeks, he developed monomorphic papulopustular eruption on his nose and back. Therefore, he was started on isotretinoin along with a dapsone gel. At follow-up after a month, his inflammatory lesions had improved. Hence, he continued the same therapy for 6 months. A 13-year-old boy, who had neurofibromatosis type I and multiple facial neurofibromas, started receiving off-label trametinib. After 4 weeks of trametinib therapy, he presented with mild inflammatory acne. He applied tretinoin cream. He had multiple comedones and an extensive monomorphic papulopustular eruption on his face, chest and back. He was started on isotretinoin. At follow up after 3 months, a clear improvement was noticed on his face and back. Hence, he continued the same therapy for 1 year. Caruana M, et al. Isotretinoin for the treatment of severe acneiform eruptions associated with the MEK inhibitor trametinib. JAAD Case Reports 6: 1056-1058, No. 10, Oct 2020. Available from: URL: http://doi.org/10.1016/j.jdcr.2020.07.021 803515069
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