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度伐利尤单抗诱发的新发环状银屑病样药疹经窄谱紫外线B光疗与局部治疗联合成功治愈。

Durvalumab-induced de novo annular psoriasiform drug eruption successfully treated with a combination of narrowband ultraviolet B phototherapy and topical treatment.

作者信息

Lin Wei-Hsi, Lee Kang-Yun, Lee Woan-Ruoh, Shih Yi-Hsien

机构信息

Department of Dermatology, Taipei Medical University- Shuang Ho Hospital, New Taipei City, Taiwan.

Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan.

出版信息

J Dermatol. 2020 Sep;47(9):1041-1045. doi: 10.1111/1346-8138.15371. Epub 2020 Jul 1.

Abstract

Immune checkpoint inhibitors, including anti-programmed death 1 and anti-programmed death ligand 1, have become prominent treatment options for various types of cancers. However, immune checkpoint inhibitors are associated with various cutaneous adverse events, one of which is psoriasiform drug eruption. Some cases of psoriasiform drug eruption can only be controlled through the cessation of immune checkpoint inhibitors and administration of systemic immunosuppressants, such as corticosteroids and methotrexate. However, no clear guideline is available on the management of this specific rash, and the use of systemic immunosuppressants is contraindicated in selected conditions. In this article, we report a case of annular psoriasiform drug eruption induced by an anti-programmed death ligand 1 monoclonal antibody, durvalumab. The patient responded well to the combination of phototherapy and topical treatment, which allowed continuation of durvalumab treatment without concomitant systemic immunosuppressants in a 2-year follow up.

摘要

免疫检查点抑制剂,包括抗程序性死亡蛋白1和抗程序性死亡配体1,已成为各类癌症的重要治疗选择。然而,免疫检查点抑制剂与多种皮肤不良事件相关,其中之一是银屑病样药疹。部分银屑病样药疹病例只能通过停用免疫检查点抑制剂并给予全身性免疫抑制剂(如皮质类固醇和甲氨蝶呤)来控制。然而,对于这种特定皮疹的管理尚无明确指南,且在某些特定情况下全身性免疫抑制剂的使用是禁忌的。在本文中,我们报告了1例由抗程序性死亡配体1单克隆抗体度伐利尤单抗引起的环状银屑病样药疹病例。该患者对光疗和局部治疗的联合治疗反应良好,在2年的随访中得以继续使用度伐利尤单抗治疗,而无需同时使用全身性免疫抑制剂。

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