First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens.
Department of Histopathology.
J Immunother. 2018 Apr;41(3):164-167. doi: 10.1097/CJI.0000000000000210.
The widespread use of immune checkpoint inhibitors has shed light to several unusual immune-related adverse effects of the drugs. Severe cutaneous adverse reactions are generally rare with anti-PD1 agents. We present in this paper the case of a 48-year-old patient with melanoma who developed bullous pemphigoid-like skin lesions along with fever, arthralgia and overt eosinophilia following adjuvant treatment with nivolumab. The condition was successfully treated with corticosteroids and a rechallenge with another anti-PD1 agent did not lead to recurrence of the skin lesions. We also reviewed the literature on the epidemiologic, clinical, and histopathologic characteristics of bullous pemphigoid as well as on the treatment and prognosis of this dermatologic condition in patients with melanoma or other malignancies under treatment with immune checkpoint inhibitors.
免疫检查点抑制剂的广泛应用揭示了这些药物的一些不常见的免疫相关不良反应。抗 PD-1 药物一般很少引起严重的皮肤不良反应。本文报道了一例 48 岁黑色素瘤患者，在接受纳武单抗辅助治疗后出现大疱性类天疱疮样皮肤病变，伴有发热、关节痛和明显嗜酸性粒细胞增多。经皮质类固醇治疗后病情得到缓解，再次使用另一种抗 PD-1 药物治疗并未导致皮肤病变复发。我们还回顾了大疱性类天疱疮的流行病学、临床和组织病理学特征，以及黑色素瘤或其他恶性肿瘤患者在接受免疫检查点抑制剂治疗时的治疗和预后。
