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阿特珠单抗诱导的银屑病样药物疹经依奇珠单抗成功治疗:一例病例报告及文献复习。

Atezolizumab-induced psoriasiform drug eruption successfully treated with ixekizumab: a case report and literature review.

机构信息

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

Dermatol Online J. 2023 Feb 15;29(1). doi: 10.5070/D329160215.

Abstract

Immune-related cutaneous adverse events (ircAE) are commonly seen with immune checkpoint inhibitors such as atezolizumab. Atezolizumab-induced psoriasis has been previously reported as an ircAE, especially in patients with pre-existing psoriasis. The severity of the reaction influences treatment of the cutaneous eruption. Biologics should be considered as a treatment option for severe refractory psoriasiform eruptions even in patients with complex medical conditions like chronic infections and malignancy. This is the first reported case of successful treatment of atezolizumab-induced psoriasiform eruption with ixekizumab, a neutralizing IL17A monoclonal antibody, to the best of our knowledge. Herein, we present a 63-year-old man with a history of human immunodeficiency virus and psoriasis who presented with atezolizumab-induced psoriasiform eruption while being treated for metastatic hepatocellular carcinoma. After initiating ixekizumab, atezolizumab was restarted without cutaneous eruption.

摘要

免疫相关的皮肤不良反应(ircAE)在免疫检查点抑制剂如阿特珠单抗等药物中很常见。阿特珠单抗诱导的银屑病以前曾被报道为 ircAE,特别是在有银屑病病史的患者中。反应的严重程度影响皮肤发作的治疗。对于严重的难治性银屑病样发作,即使在患有慢性感染和恶性肿瘤等复杂疾病的患者中,也应考虑使用生物制剂作为治疗选择。据我们所知,这是首例使用中和白细胞介素 17A 单克隆抗体依奇珠单抗成功治疗阿特珠单抗诱导的银屑病样发作的病例。在此,我们报告了 1 例 63 岁男性病例,该患者有人类免疫缺陷病毒和银屑病病史,在转移性肝细胞癌治疗期间发生了阿特珠单抗诱导的银屑病样发作。开始使用依奇珠单抗后,重新开始使用阿特珠单抗而没有出现皮肤发作。

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