Mullangi Sanjana, Ponnam Sreeja, Lekkala Manidhar Reddy, Koya Supriya
Internal Medicine, Hillcrest Medical Center, Tulsa, USA.
Neurosurgery, Oklahoma Surgical Hospital, Tulsa, USA.
Cureus. 2021 Jun 16;13(6):e15703. doi: 10.7759/cureus.15703. eCollection 2021 Jun.
Immune-mediated adverse events are commonly seen with immune checkpoint inhibitors like nivolumab. Oncology specialists usually have to screen patients for risk factors for autoimmune diseases, since immune checkpoint inhibitors can potentially exacerbate these events. Some of the immune-mediated side effects include polyneuropathies, colitis, and cutaneous adverse effects. Non-specific maculopapular rash, pruritus, lichenoid reactions, eczema, and vitiligo are the most common dermatologic side effects. It is thought that these adverse events are due to the blocking of the programmed cell death protein-1 (PD-1) pathway and are mediated by the cytotoxic T cells. Psoriasis has been previously reported as a side effect in a few case reports and most commonly presented as an exacerbation of preexisting psoriasis. However, de novo psoriasis occurrence as a result of nivolumab is a rare entity, especially in a non-melanoma patient. Here, we present a case of renal cell carcinoma treated with immunotherapy with nivolumab, who developed de novo psoriasis with palmoplantar involvement.
免疫介导的不良事件在使用纳武单抗等免疫检查点抑制剂时很常见。肿瘤学专家通常必须对患者进行自身免疫性疾病风险因素筛查，因为免疫检查点抑制剂可能会加重这些事件。一些免疫介导的副作用包括多发性神经病、结肠炎和皮肤不良反应。非特异性斑丘疹、瘙痒、苔藓样反应、湿疹和白癜风是最常见的皮肤副作用。据认为，这些不良事件是由于程序性细胞死亡蛋白1（PD-1）通路受阻，并由细胞毒性T细胞介导。银屑病此前在一些病例报告中被报道为副作用，最常见的表现是原有银屑病的加重。然而，由于纳武单抗导致的新发银屑病是一种罕见情况，尤其是在非黑色素瘤患者中。在此，我们报告一例接受纳武单抗免疫治疗的肾细胞癌患者，该患者出现了累及掌跖的新发银屑病。
