Maarouf Melody, Alexander Christina, Shi Vivian Y
College of Medicine, University of Arizona, Tucson, Arizona.
Dermatol Online J. 2018 Jan 15;24(1):13030/qt4xf465w6.
We report a case of nivolumab-induced lichen planus (LP) reactivation that was previously in remission following chemotherapy for non-smallcelllung cancer (NSCLC). Chemotherapy-induced immunosuppression allowed for complete resolution of the patient's pre-existing LP, a T-cell mediatedautoimmune process. When the patient was switched to nivolumab immunotherapy owing to progression of NSCLC, PD-1 inhibition led to an overwhelming T-cell response that seemed to have provoked a severe LPreactivation. Although lichenoid reactions have been reported with nivolumab, to our knowledge, this is the first reported case of nivolumab monotherapycausing LP reactivation in a patient with a strong personal and family history of the disease that was previously in remission after chemotherapy.
我们报告了一例由纳武单抗引起的扁平苔藓(LP)再激活病例,该患者此前因非小细胞肺癌(NSCLC)接受化疗后病情缓解。化疗诱导的免疫抑制使患者先前存在的LP(一种T细胞介导的自身免疫过程)完全消退。当患者因NSCLC进展而改用纳武单抗免疫治疗时,PD-1抑制导致了强烈的T细胞反应,似乎引发了严重的LP再激活。尽管已有使用纳武单抗后出现苔藓样反应的报道,但据我们所知,这是首例有明确个人和家族病史且此前化疗后病情缓解的患者,使用纳武单抗单药治疗导致LP再激活的病例。