Lichenoid drug reaction after ipilimumab/nivolumab combination therapy: A case report.

Nivolumab (PD-1 inhibitor) and ipilumumab (CTLA-4 inhibitor) are recently approved checkpoint inhibitors for treatment of non-small cell lung cancer. Immune-related adverse events related to the usage of checkpoint inhibitors are growing with their popularity. We present the case of a patient in combination treatment of nivolumab and ipilimumab who developed a lichenoid drug reaction, notable because it worsened to a bullous lichenoid drug reaction. Treatment with prednisone and withdrawal of checkpoint inhibitors aided in clinical resolution. Initial presentation of a lichenoid reaction that progressed to a bullous, desquamated presentation indicates the possibility of the prodromal rash progressing to a Stevens-Johnson Syndrome-like dermatosis. When dermatologists are consulted for rashes developed during checkpoint-inhibitor therapy, they should be aware that early treatment may prevent progression to bullae formation and desquamation and develop their treatment plans with this in mind.

Combination of Medical and Surgical Treatment in Scleromyxedema.

Scleromyxedema is an uncommon and progressive fibromucinous disorder characterized by disseminated papular eruption with histological features of dermal mucin deposition. The skin changes associated with this disease are highly visible and they tend to affect the patient's quality of life. We report a case of a 50-year-old male patient that presented a 3-year-old history of disseminated asymptomatic firm papules-associated systemic symptoms. Medical treatment with oral corticosteroid and thalidomide was indicated and surgical treatment on residual facial folds was performed, with an excellent outcome.