Cutaneous adverse event associated with vemurafenib in a 3-year-old pediatric patient with BRAF mutation-positive metastatic melanoma and factor X deficiency

Abstract

Malignant melanoma is very rare in childhood. The approach to diagnosis and treatment in children has been adopted from adult guidelines. Vemurafenib is indicated in adults with BRAF V600 mutation-positive stage IIIc/IV melanoma and causes cutaneous adverse events. We report on a 3-year-old child with recurrent, metastatic (bone) BRAF mutation-positive melanoma. He also had severe factor X deficiency. Four days after vemurafenib treatment, bilateral palpebral edema and violet-colored hyperpigmentation were observed. There was no objective response to vemurafenib; however, bone pain regressed slightly. Our patient is the youngest patient who received vemurafenib for BRAF V600 mutation-positive metastatic melanoma in the literature.