J Drugs Dermatol. 2022 May 1;21(5):529-530. doi: 10.36849/JDD.6559.
Nivolumab (anti PD-1 antibody) and ipilimumab (anti CTLA-4 antibody) are immune checkpoint inhibitors (ICI) that effectively stimulate the native T cell response and lead to an antitumor response. The medications have been approved for the treatment of metastatic melanoma. However, ICIs are associated with higher risk for cutaneous immune-related adverse events (irAEs). Although most of the adverse events present as maculopapular rash, some patients develop Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis which are dermatologic emergencies with high mortality. We report a fatal case of SJS associated with nivolumab and a non-fatal case of TEN with nivolumab/ipilimumab combination therapy in patients with metastatic melanoma. It is also not unusual to develop SJS or TEN after weeks or months on checkpoint inhibitor therapy. Given the high rate for mortality, dermatologists and other clinicians should closely follow any rash from these immunotherapies due to the risk for future development of SJS or TEN. J Drugs Dermatol. 2022;21(5):529-530. doi:10.36849/JDD.6559.
纳武利尤单抗（抗 PD-1 抗体）和伊匹单抗（抗 CTLA-4 抗体）是免疫检查点抑制剂（ICI），可有效刺激天然 T 细胞反应，从而引发抗肿瘤反应。这些药物已被批准用于治疗转移性黑色素瘤。然而，ICI 与皮肤免疫相关不良反应（irAE）的风险增加相关。尽管大多数不良反应表现为斑丘疹，但有些患者会出现史蒂文斯-约翰逊综合征（SJS）或中毒性表皮坏死松解症，这是具有高死亡率的皮肤科急症。我们报告了一例与纳武利尤单抗相关的 SJS 致死病例和一例与纳武利尤单抗/伊匹单抗联合治疗相关的 TEN 非致死病例。在接受检查点抑制剂治疗数周或数月后，也会出现 SJS 或 TEN。鉴于死亡率较高，皮肤科医生和其他临床医生应密切关注这些免疫疗法引起的任何皮疹，因为未来可能会发展为 SJS 或 TEN。《皮肤病药物杂志》。2022;21(5):529-530. doi:10.36849/JDD.6559.
