Cushman Caroline J, Abaleka Fuad, Ibrahim Andrew F, Yalamanchili Kiran, Thirumala Seshadri, Quick Donald
Department of Medicine, Texas Tech University Health Science Center, Lubbock, TX 79430, USA.
Department of Medicine, Covenant Health, Lubbock, TX 79410, USA.
Reports (MDPI). 2024 Nov 4;7(4):91. doi: 10.3390/reports7040091.
Radiation recall dermatitis (RRD) following immune checkpoint inhibitor (ICI) therapy has been infrequently reported. We present a 47-year-old female patient who developed RRD of the breast following three doses of pembrolizumab administered as an adjuvant treatment post-nephrectomy for Stage III renal cell carcinoma (RCC). Notably, the affected breast had previously undergone external beam radiotherapy 247 weeks earlier for Stage IA invasive ductal carcinoma. She had received no prior chemotherapy at any point. RRD manifested as breast induration, erythema, and peau d'orange, and contraction of breast volume was noted following three cycles of pembrolizumab on week 17 (400 mg dose every 6 weeks). The dermatitis responded rapidly to systemic corticosteroids and no treatment interruption was needed. To date, this is the longest reported interval from completion of radiotherapy to RRD. A literature search underscores the variability in presentation and management of ICI-associated RRD.
免疫检查点抑制剂（ICI）治疗后发生放射性回忆性皮炎（RRD）的报道较少。我们报告一名47岁女性患者，她在接受三剂帕博利珠单抗作为Ⅲ期肾细胞癌（RCC）肾切除术后辅助治疗后，出现了乳腺RRD。值得注意的是，患侧乳房曾在247周前因IA期浸润性导管癌接受过体外放射治疗。她此前从未接受过化疗。RRD表现为乳腺硬结、红斑和橘皮样改变，在第17周接受三个周期的帕博利珠单抗治疗（每6周400mg剂量）后，发现乳房体积缩小。皮炎对全身性皮质类固醇反应迅速，无需中断治疗。迄今为止，这是报道的从放疗结束到RRD出现的最长间隔时间。文献检索强调了ICI相关RRD在表现和管理方面的变异性。
