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April 8, 2020

Treatment of Trametinib-Associated Folliculitis Eruption With Fluconazole

Author Affiliations
  • 1School of Medicine, University of North Carolina, Chapel Hill
  • 2Department of Neurology, University of North Carolina, Chapel Hill
  • 3Department of Dermatology, University of North Carolina, Chapel Hill
JAMA Dermatol. 2020;156(6):706-708. doi:10.1001/jamadermatol.2020.0284

Trametinib, an orally administered commercially available MEK inhibitor (MEKi), is currently being investigated in the treatment of surgically inoperable tumors associated with neurofibromatosis type 1 (NF1).1,2 A potential benefit of trametinib for plexiform neurofibromas is suggested by the effectiveness of the MEKi selumetinib in previous studies.3 Trametinib and selumetinib both have the potential to cause cutaneous toxic reactions, most frequently folliculitis eruptions, that can require dosage modifications or drug discontinuation.4,5 These rashes are treated with a variety of therapies with differing rates of success.4 In this case report, we describe a series of 5 patients with NF1 and surgically inoperable plexiform neurofibromas being treated with trametinib. These patients developed folliculitis eruptions and were treated with oral fluconazole after biopsies in 2 patients showed evidence of fungal involvement.

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