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The Cutting Edge: Challenges in Medical and Surgical Therapies |

A Novel Therapeutic Combination Approach for Treating Multiple Vemurafenib-Induced Keratoacanthomas Systemic Acitretin and Intralesional Fluorouracil

Lindsay LaPresto, BS; Lee Cranmer, MD, PhD; Lynne Morrison, RN; Christof P. Erickson, MD; Clara Curiel-Lewandrowski, MD
JAMA Dermatol. 2013;149(3):279-281. doi:10.1001/jamadermatol.2013.2583.
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Correspondence: Clara Curiel-Lewandrowski, MD, The University of Arizona Cancer Center, 1515 N Campbell Ave, PO Box 245024, Tucson, AZ 85724 (ccuriel@azcc.arizona.edu).

Accepted for Publication: October 30, 2012.

Author Contributions: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Cranmer and Curiel-Lewandrowski. Acquisition of data: Cranmer, Morrison, Erickson, and Curiel-Lewandrowski. Analysis and interpretation of data: LaPresto, Erickson, and Curiel-Lewandrowski. Drafting of the manuscript: LaPresto, Cranmer, Morrison, and Curiel-Lewandrowski. Critical revision of the manuscript for important intellectual content: Cranmer and Erickson. Administrative, technical, and material support: Cranmer, Morrison, Erickson, and Curiel-Lewandrowski. Study supervision: Curiel-Lewandrowski.

Conflict of Interest Disclosure: Dr Cranmer discloses that he is a paid speaker for Genentech.

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Clinicians, residents, and fellows are invited to submit cases of challenges in management and therapeutics to this section. Cases should follow the established pattern. Manuscripts should be prepared double-spaced with right margins nonjustified. Pages should be numbered consecutively with the title page separated from the text (see Instructions for Authors [www.jamaderm.com] for information about preparation of the title page). Clinical photographs, photomicrographs, and illustrations must be sharply focused and submitted as separate JPG files with each file numbered with the figure number. Material must be accompanied by the required copyright transfer statement. Manuscripts should be submitted via our online manuscript submission and review system (http://manuscripts.jamaderm.com).

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Figure 1. Clinical image before treatment of biopsy-proven squamous cell carcinoma–keratoacanthoma type. Clinical image at initial dermatological evaluation demonstrates multiple keratotic papules measuring from 3 to 5 mm in diameter on the lower extremities, clinically consistent with keratoacanthomas.

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Figure 2. Clinical image after treatment of biopsy-proven squamous cell carcinoma–keratoacanthoma type. The follow-up image taken 2 weeks later demonstrates a significant resolution of the keratoacanthomas following treatment with intralesional fluorouracil and acitretin.

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