BRAF is a gene of the RAF family of kinases, frequently mutated in benign and malignant melanocytic tumors (nevi and melanomas). Organ transplant recipients are at high risk for developing various tumors, including melanocytic ones. We studied a group of 129 melanocytic tumors including various subtypes of nevi (n: 114) and melanomas (n: 15) excised from transplant (n: 63) and control (non-immunosuppressed) patients (n: 66) as to BRAF mutation status. Mutation research was performed after extraction of DNA from archival material (paraffin-embedded tissue specimens) by sequence analysis. BRAFV600E accounted for the most prevalent mutation found (94%). Melanocytic tumors from transplant patients had a lower frequency of BRAF mutations than control lesions (45.4% vs 63.5%, p<.05). The explanation for this difference is currently unknown. The possibility exists that in transplant patients, factors linked to immunosuppression (most likely immunosuppressive drugs) induce additional mutations, or activate alternative signaling pathways, which compensates for the lower rate of activating BRAF mutations in tumors developing in these patients.
Background: the present multicenter retrospective study aimed to evaluate the efficacy and safety of intra-class switching between interleukin-17A (IL-17A) inhibitors, specifically from ixekizumab to secukinumab, in patients with plaque psoriasis. Methods: this study included 11 patients (6 male, 5 female) who had previously received ixekizumab and then were switched to secukinumab. Patients’ PASI, DLQI, and pain VAS (in those with psoriatic arthritis) were evaluated at weeks 16, 24, 54, and 98. Results: PASI-90 was reached in 10 (91%) cases at week 24. One patient experienced secondary failure to secukinumab at week 98. No adverse events were reported. Conclusions: overall, the majority of patients experienced a favorable response to secukinumab, suggesting that it may be an effective treatment option for patients with an inadequate response or loss of efficacy to ixekizumab.
1 February 2018 in Journal of the American Academy of Dermatology