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Table 3 Practical Advice for Clinical Management

From: Cutaneous adverse reactions in B-RAF positive metastatic melanoma following sequential treatment with B-RAF/MEK inhibitors and immune checkpoint blockade or vice versa. A single-institutional case-series

- Consult dermatology and biopsy right away, photographs recommended to help document rash.
- Consider obtaining CRP as surrogate for IL-6 as patients may present with SIRS.
- Consider re-initiation of therapy after rash (at lower dose, with steroid overlap), particularly if no signs of SJS, biopsy appears benign relative to clinical rash, and patient was having a good response to the therapy or does not have alternate therapy options.
- Consider avoidance of other stimulating medications or known activating medications such as amoxicillin, amoxicillin-clavulanic acid, allopurinol