The discovery of BRAF mutation in ~50% of melanomas led to the development of small molecule BRAF inhibitors, including sorafenib, debrafenib, and vemurafenib. Clinical trials have shown these agents to be effective in treatment of metastatic and locally advanced melanoma, increasing overall and progression-free survival. However, some of the most common toxicities associated with BRAF inhibitor therapy include adverse skin events such as rashes, photosensitivity, hyperkeratosis, papillomas, keratoacanthomas, and squamous cell carcinomas. Here, the authors describe 3 patients who developed keratinocytic neoplasms on the eyelid, including invasive squamous carcinoma secondary to vemurafenib. Vigilant screening and a high index of suspicion for eyelid carcinomas are recommended in patients treated with vemurafenib.
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