case_images: PMC11147515_01
case_images: New dark brown to black macules and papules of the face (a), neck (b), left arm (c), and back (d) that developed within 10 weeks after initiating encorafenib, cetuximab, and binimetinib combination therapy.
case_images: cde-2024-0016-0001-539058_F01.jpg
case_images: PMC11147515_01_cde-2024-0016-0001-539058_F01.jpg
case_images: F1
case_images: Over the next 8 weeks while continuing on this regimen, she continued to develop over 200 additional lesions on her oral labia, shoulders, arms, palms, and buttocks (Fig. 1a-d).
case_images: New dark brown to black papules on the posterior left shoulder (a), with fibrillar pigment network on dermoscopy (b).
case_images: cde-2024-0016-0001-539058_F02.jpg
case_images: PMC11147515_01_cde-2024-0016-0001-539058_F02.jpg
case_images: F2
case_images: On dermatoscopy, the lesions demonstrated a fibrillar network pattern with focal areas of irregularity and non-perifollicular pigment dropout (Fig. 2a, b).
case_images: Punch biopsy of a 4-mm dark brown macule on the patient's right upper arm was obtained. Immunohistochemistry for BRAF V600E showed negative staining in rare dermal melanocytic nests. H&E x10 demonstrated a moderately atypical compound melanocytic nevus.
case_images: cde-2024-0016-0001-539058_F03.jpg
case_images: PMC11147515_01_cde-2024-0016-0001-539058_F03.jpg
case_images: F3
case_images: A punch biopsy of a lesion on the right upper arm was performed, which demonstrated a compound melanocytic proliferation with moderate atypia and negative staining for BRAF V600E (Fig. 3).