Clinicopathologically supported photodistributed hyperpigmentation with associated nail changes during adagrasib therapy

Adagrasib is a selective KRAS G12C inhibitor increasingly used in advanced malignancies and is associated with a range of cutaneous adverse effects. However, pigmentary changes remain rarely reported. We report a patient with recurrent KRAS G12C–mutant non–small cell lung cancer who developed photodistributed hyperpigmentation with associated nail matrix changes following adagrasib therapy.