University of Michigan Medical School, Ann Arbor, MI.
Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.
J Immunother. 2024 Apr 1;47(3):98-100. doi: 10.1097/CJI.0000000000000498. Epub 2023 Nov 27.
Immune checkpoint inhibitors are increasingly being utilized for the treatment of advanced neoplastic disease and have been associated with wide-ranging cutaneous adverse effects. Though exceedingly rare, eruptive keratoacanthomas have been associated with the use of immune checkpoint inhibitors such as pembrolizumab and nivolumab, whose molecular target is the programmed cell death protein 1. Herein, we detail a case of numerous eruptive keratoacanthomas arising in a patient one month after initiation of nivolumab for recurrent metastatic oropharyngeal squamous cell carcinoma. Treatment with multiple rounds of intralesional corticosteroids and a several-month course of oral acitretin resulted in partial improvement. Subsequent treatment with intralesional 5-fluorouracil demonstrated near-complete resolution of the keratoacanthomas without discontinuation of nivolumab. Although eruptive keratoacanthomas secondary to immune checkpoint inhibitors are exceptionally rare, physicians should be aware of this cutaneous adverse effect as their use becomes more widespread.
免疫检查点抑制剂越来越多地被用于治疗晚期肿瘤疾病，并与广泛的皮肤不良反应相关。虽然极其罕见，但爆发性角化棘皮瘤与免疫检查点抑制剂的使用有关，如 pembrolizumab 和 nivolumab，其分子靶点是程序性细胞死亡蛋白 1。在此，我们详细介绍了一例复发性转移性口咽鳞状细胞癌患者在接受 nivolumab 治疗一个月后出现多发性爆发性角化棘皮瘤的病例。经过多次局部皮质类固醇治疗和数月的口服阿维 A 治疗，病情有所改善。随后采用局部 5-氟尿嘧啶治疗，角化棘皮瘤几乎完全消退，且无需停用 nivolumab。虽然免疫检查点抑制剂引起的爆发性角化棘皮瘤极为罕见，但随着其应用的广泛，医生应了解这种皮肤不良反应。
