Bhatia Divya, Gupta Ekta, Bains Anupama, Vedant Deepak
Dermatology, All India Institute of Medical Sciences, Jodhpur, IND.
Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, IND.
Cureus. 2025 Mar 31;17(3):e81542. doi: 10.7759/cureus.81542. eCollection 2025 Mar.
Nivolumab is a human IgG4, PD-1 inhibitor that is approved for the treatment of advanced melanoma. We hereby report a patient of metastatic melanoma who developed multiple cutaneous side effects, including Sweet's syndrome, lichenoid eruption, and vitiligo-like depigmentation after initiation of the nivolumab therapy. He first started developing vitiligo-like depigmentation over the lips, which appeared after five months. Later, he developed a mildly itchy lichenoid eruption over the thighs. The most recent and disabling one was the appearance of erythematous edematous painful plaques studded with pustules and vesicles with fever. The latter was diagnosed as Sweet's syndrome. Nivolumab was stopped, and the patient was started on oral dapsone 100 mg per day with topical mometasone 0.1% cream once a day application for these lesions. The patient had complete resolution of edematous plaques after four weeks of follow-up. Also, the subsequent dose of nivolumab was decreased by 20%, and this was not followed by the recurrence of Sweet's syndrome; however, vitiligo-like depigmentation persisted.
纳武单抗是一种人IgG4型程序性死亡受体1（PD-1）抑制剂，已被批准用于治疗晚期黑色素瘤。我们在此报告一名转移性黑色素瘤患者，在开始使用纳武单抗治疗后出现了多种皮肤副作用，包括Sweet综合征、苔藓样皮疹和白癜风样色素脱失。他首先在嘴唇上出现白癜风样色素脱失，这是在五个月后出现的。后来，他在大腿上出现了轻度瘙痒的苔藓样皮疹。最近且最严重的是出现了伴有发热的、布满脓疱和水疱的红斑性水肿性疼痛斑块。后者被诊断为Sweet综合征。停用了纳武单抗，开始让患者每天口服100毫克氨苯砜，并每天一次外用0.1%莫米松乳膏治疗这些皮损。经过四周的随访，患者的水肿性斑块完全消退。此外，随后将纳武单抗的剂量降低了20%，此后未再出现Sweet综合征复发；然而，白癜风样色素脱失仍然存在。
