Tumoral melanosis associated with combined BRAF/MEK inhibition (dabrafenib/trametinib) in metastatic melanoma

Tumoral melanosis describes a pigmented lesion clinically suspicious for melanoma but characterized histopathologically by aggregates of melanin-laden macrophages without malignant cells.1,2 Limited cases of tumoral melanosis exist in the literature; often it is identified on the skin as a macule or papule or may present in the lymph nodes of a patient with a history of melanoma or a longstanding atypical lesion, and further investigation can yield undiagnosed local or metastatic disease.2,3 Recently, there are examples of tumoral melanosis arising during treatment for melanoma, mostly with anti-PD-1 or anti-CTLA-4 therapy.