Asunto(s)
Dermoscopía , Microscopía Confocal , Síndrome de Muir-Torre , Humanos , Dermoscopía/métodos , Microscopía Confocal/métodos , Femenino , Síndrome de Muir-Torre/patología , Síndrome de Muir-Torre/genética , Síndrome de Muir-Torre/diagnóstico por imagen , Masculino , Pigmentación de la Piel , Adulto , Piel/patología , Piel/diagnóstico por imagen , Persona de Mediana EdadAsunto(s)
Enfermedades Autoinmunes , Bases de Datos Factuales , Rosácea , Humanos , Rosácea/epidemiología , Rosácea/diagnóstico , Estudios de Casos y Controles , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/inmunología , Femenino , Masculino , Persona de Mediana Edad , Adulto , Estados Unidos/epidemiología , Bases de Datos Factuales/estadística & datos numéricos , Anciano , Adulto Joven , AdolescenteRESUMEN
While typically low-risk, cutaneous squamous cell carcinoma (cSCC) can infrequently progress to metastatic disease with in-transit lesions, localized to the dermis or subcutaneous tissue between the primary tumor and draining regional lymph nodes. These lesions are associated with poor prognostic values, including decreased survival rates and increased risk of recurrence. We present the case of a 75-year-old male with cSCC and in-transit metastases on his scalp treated with the immune checkpoint inhibitor (ICI) pembrolizumab in conjunction with diphencyprone (DPCP), a topical hapten that induces a delayed-type hypersensitivity reaction in the skin. The patient was enrolled in a clinical trial (NCT05481658) that involved the twice-weekly application of DPCP 0.04% ointment to four of the in-transit metastases on his frontal scalp, concurrent with pembrolizumab 300 mg administered every three weeks. Following effective sensitization and a twelve-week treatment course, complete clearance of all lesions, DPCP-treated and non-DPCP treated, was achieved, with no adverse events. The immunologic profiles of the post-treatment biopsies were analyzed by TaqMan Low Density Array quantitative real-time polymerase chain reaction to measure immune marker gene expression. Relative to the non-DPCP-treated lesion, the DPCP-treated lesion demonstrated increased pro-inflammatory genetic markers and T-cell activation. This case represents the first reported instance of in-transit metastases of cSCC successfully treated with DPCP and an ICI. It highlights the potential safety and efficacy of DPCP with systemic immunotherapy for the management of in-transit metastases of cSCC in patients for whom surgery and radiation may be contraindicated.
Asunto(s)
Bases de Datos Factuales , Penfigoide Ampolloso , Humanos , Estudios de Casos y Controles , Femenino , Masculino , Estados Unidos/epidemiología , Persona de Mediana Edad , Anciano , Adulto , Penfigoide Ampolloso/epidemiología , Hipersensibilidad Inmediata/epidemiología , Adolescente , Anciano de 80 o más Años , Adulto JovenAsunto(s)
Bases de Datos Factuales , Dermatitis Atópica , Humanos , Dermatitis Atópica/epidemiología , Dermatitis Atópica/complicaciones , Estudios de Casos y Controles , Femenino , Masculino , Estados Unidos/epidemiología , Adulto , Persona de Mediana Edad , Linfoma/epidemiología , Linfoma/complicaciones , Adolescente , Adulto Joven , Medición de Riesgo/estadística & datos numéricos , Anciano , Niño , IncidenciaRESUMEN
Melanoma case reports show variations in treatment by age and sex.
Asunto(s)
Bibliometría , Melanoma , Neoplasias Cutáneas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Edad , Melanoma/patología , Melanoma/epidemiología , Melanoma/terapia , Factores Sexuales , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/terapia , Informes de Casos como AsuntoRESUMEN
In this report, we describe the case of a 28-year-old female with bilateral breast cancer in the setting of a BRCA1 mutation, who presented to dermatology with an eczematous reaction, ultimately diagnosed as a cutaneous immune-related adverse event (cirAE) secondary to an immune checkpoint inhibitor (ICI), pembrolizumab. Our case report highlights a novel therapeutic option for an eczematous cirAE: the topical JAK 1/2 inhibitor, ruxolitinib. CirAEs can occur in up to 55% of patients on ICIs, a class of medications seeing rapidly increasing use in cancer therapy, and prior research has demonstrated that ICI-induced dermatitis may involve different pathways than traditionally observed in their spontaneous counterparts. Specifically, marked Th1 skewing is noted in ICI-induced dermatitis, as opposed to a predominant Th2 response which typically characterizes spontaneous atopic dermatitis. To our knowledge, this is the first case report in the literature discussing use of a topical JAK inhibitor, ruxolitinib, in the treatment of topical steroid-refractory cirAEs. Furthermore, as topical JAK inhibitors are thought to not carry the risks of systemic JAK inhibitors, including malignancy, ruxolitinib cream is a promising therapeutic option for this challenging patient population.