Topical Trametinib for Agminated Spitz Nevi Harboring HRAS Mutation.
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The treatment of agminated Spitz nevi can be challenging due to the potential for disfigurement in cosmetically sensitive areas. We report the case of a pediatric patient with progressive agminated Spitz nevi arising from a nevus spilus on the face with an associated pathogenic HRAS p.G13R mutation revealed on next-generation sequencing (NGS). The patient was treated with compounded topical trametinib 1% cream and demonstrated significant clinical improvement following 12 weeks of twice-daily treatment. Our case highlights the potential role of MEK inhibition as a targeted, non-surgical treatment for HRAS-mutated agminated Spitz nevi and adds to the growing understanding of their genetic etiology.