RESUMEN
Pembrolizumab is an immune checkpoint inhibitor used in many cancer types, including genitourinary cancers. Although immunotherapies have dramatically changed the landscape of cancer treatment by providing an alternative to traditional chemotherapy, they have been associated with significant immune-related adverse events (IRAEs) with wide-ranging clinical manifestations. We present the case of an elderly woman on pembrolizumab for metastatic bladder cancer who developed cutaneous IRAE with lichenoid eruptions that responded to high-dose intravenous glucocorticoids.
Asunto(s)
Erupciones Liquenoides , Neoplasias , Femenino , Humanos , Anciano , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Erupciones Liquenoides/inducido químicamente , Erupciones Liquenoides/tratamiento farmacológico , Neoplasias/tratamiento farmacológicoRESUMEN
Lichenoid tissue reaction/interface dermatitis represents a class of mucocutaneous inflammatory diseases which share common histopathological manifestations. One patient presented to our clinic whose oral lesions could not categorized into a definitely clinical or pathological diagnosis, but could be ascribed to lichenoid tissue reaction/interface dermatitis with moderate-to-severe dysplasia. Photodynamic treatment was applied in this case and a satisfactory result was eventually achieved. Signs of recurrence were not revealed at the follow-up of the tenth month.
Asunto(s)
Dermatitis , Erupciones Liquenoides , Fotoquimioterapia , Dermatitis/diagnóstico , Dermatitis/patología , Dermatitis/terapia , Humanos , Erupciones Liquenoides/inducido químicamente , Erupciones Liquenoides/diagnóstico , Erupciones Liquenoides/tratamiento farmacológico , Fotoquimioterapia/métodosRESUMEN
We present a 53-year-old woman with severe lichenoid dermatitis secondary to pembrolizumab therapy that was refractory to both topical and oral steroids. After almost three months without improvement, the rash was effectively combated with a single 15mg dose of methotrexate. We hope this case will help guide the management of the cutaneous adverse effects of anti-PD1 immunotherapy.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos Inmunológicos/efectos adversos , Inmunosupresores/administración & dosificación , Erupciones Liquenoides/tratamiento farmacológico , Metotrexato/administración & dosificación , Femenino , Humanos , Erupciones Liquenoides/inducido químicamente , Erupciones Liquenoides/patología , Melanoma/tratamiento farmacológico , Persona de Mediana EdadRESUMEN
is missing (Short communication).
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos Inmunológicos/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones Liquenoides/inducido químicamente , Enfermedades de la Boca/inducido químicamente , Micosis Fungoide/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Administración Cutánea , Corticoesteroides/administración & dosificación , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/tratamiento farmacológico , Femenino , Humanos , Erupciones Liquenoides/diagnóstico , Erupciones Liquenoides/tratamiento farmacológico , Persona de Mediana Edad , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/tratamiento farmacológico , Inducción de Remisión , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adolescente , Erupciones Liquenoides/diagnóstico , Erupciones Liquenoides/tratamiento farmacológico , Dermatitis/tratamiento farmacológico , Dermatitis/diagnóstico , Clobetasol/uso terapéuticoRESUMEN
Annular lichenoid dermatitis of youth (ALDY), first described in 2003, represents an uncommon entity whose etiopathogenesis is still debated. Futhermore, the optimal treatment for ALDY is yet to be established. We report a 9-year-old girl who presented with annular and oval erythematous lesions mostly on her trunk, with several lesions on the neck, groin, flanks, and upper extremities. The lesions had histological and immunohistochemical features characteristic for ALDY. Treatment with H1-antihistamines, topical corticosteroid, and UVB therapy was unsuccessful, while systemic treatment with cyclosporine induced complete remission.
Asunto(s)
Erupciones Liquenoides , Neurodermatitis , Administración Cutánea , Adolescente , Niño , Ciclosporina/uso terapéutico , Femenino , Humanos , Erupciones Liquenoides/inducido químicamente , Erupciones Liquenoides/diagnóstico , Erupciones Liquenoides/tratamiento farmacológico , PielRESUMEN
The increased use of monoclonal antibodies that target the immune checkpoint T cell receptor programmed death-1 (PD1) to treat numerous solid tumors has led to several reports describing associated cutaneous adverse events. Although lichenoid reactions have been well described, we propose that PD1 inhibitor-induced inverse lichenoid eruption (PILE) is a distinct variant. We describe two patients who presented with nearly identical deeply erythematous, malodorous, eroded anogenital plaques with focal crusting. Diagnosis of PILE was established given the biopsy findings and temporal association with PD1 inhibitor therapy. Treatment with clobetasol ointment was successful without necessitating discontinuation of immunotherapy. The findings were consistent with the only other previously published case of inverse lichenoid eruption in the groin secondary to PD1 inhibitors.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Erupciones Liquenoides/patología , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Abdomen/patología , Adenocarcinoma/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Nalgas/patología , Clobetasol/administración & dosificación , Femenino , Glucocorticoides/administración & dosificación , Humanos , Erupciones Liquenoides/tratamiento farmacológico , Erupciones Liquenoides/etiología , Neoplasias Pulmonares/tratamiento farmacológico , Persona de Mediana Edad , Pomadas , Perineo/patología , Piel/patologíaRESUMEN
Rifampicin is an essential first line anti-tuberculosis drug. However, several cases of adverse reactions associated with this drug have been reported, the most common of which are cutaneous drug reactions. We report a case of mixed lichenoid and psoriasiform drug eruption induced by rifampicin.
Asunto(s)
Antituberculosos/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones Liquenoides/inducido químicamente , Psoriasis/inducido químicamente , Rifampin/efectos adversos , Antituberculosos/administración & dosificación , Erupciones por Medicamentos/tratamiento farmacológico , Humanos , Erupciones Liquenoides/tratamiento farmacológico , Psoriasis/tratamiento farmacológico , Rifampin/administración & dosificaciónRESUMEN
Programmed cell death receptor 1 inhibitors (anti-PD-1) constitute a form of immunotherapy for the treatment of several cancers. They are associated with cutaneous immune-related adverse events (irAE), occurring in up to 50% of patients. Lichenoid dermatitis is frequent and several presentations have been described. Although attempts have been made to study these reactions, they are yet to be fully characterized and the relationship with tumor response is unclear. We describe a case of digital ulcerative lichenoid dermatitis resembling ulcerative cutaneous lichen planus that occurred during pembrolizumab therapy for oral squamous cell carcinoma. The patient developed a painful ulcer on his index finger 18 months into therapy. Biopsy revealed epidermal ulceration with intense lichenoid dermatitis. Immunohistochemical study revealed intense CD8 positivity at the ulcer's edges and marked CD163 positivity at its base. Although idiopathic forms of this type of lichenoid dermatitis are particularly recalcitrant, our case was successfully managed with topical therapy and oncologic treatment did not require modification. One year after ending treatment the patient remains free of disease progression. It is unclear if this reaction is associated with his favorable oncologic response. This report adds an undescribed reaction to the increasing diversity of cutaneous irAE associated with anti-PD-1 therapy.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos Inmunológicos/efectos adversos , Erupciones Liquenoides/inducido químicamente , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Úlcera Cutánea/inducido químicamente , Administración Cutánea , Anciano , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Betametasona/administración & dosificación , Betametasona/análogos & derivados , Carcinoma de Células Escamosas/tratamiento farmacológico , Combinación de Medicamentos , Gentamicinas/administración & dosificación , Humanos , Erupciones Liquenoides/tratamiento farmacológico , Erupciones Liquenoides/patología , Masculino , Neoplasias de la Boca/tratamiento farmacológico , Piel/patología , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/patologíaAsunto(s)
Dermatitis/diagnóstico , Erupciones Liquenoides/diagnóstico , Adolescente , Adulto , Clobetasol/administración & dosificación , Dermatitis/tratamiento farmacológico , Dermatitis/patología , Diagnóstico Diferencial , Femenino , Humanos , Erupciones Liquenoides/tratamiento farmacológico , Erupciones Liquenoides/patología , Masculino , Tacrolimus/administración & dosificaciónRESUMEN
A 22-year-old female presented with generalised lichenification and severe pruritus, along with multiple annular papules and concentric plaques over trunk and extremities for the last 3 years. Her haematological investigations revealed leucocytosis with peripheral blood eosinophilia and raised serum IgE levels. Skin biopsy showed perivascular and interstitial infiltrate of eosinophils and lymphocytes in the dermis. Bone marrow examination showed myeloid hypercellularity with increased number of eosinophils, but no atypical cells. Cytogenetic studies did not reveal any chromosomal alterations. No systemic involvement was found on imaging. A diagnosis of idiopathic skin-limited hypereosinophilic syndrome was made. She was treated with tapering doses of oral prednisolone and weekly methotrexate with significant improvement in skin lesions and pruritus in 2 months, which was maintained at 7-month follow-up.
Asunto(s)
Eritema/tratamiento farmacológico , Síndrome Hipereosinofílico/tratamiento farmacológico , Erupciones Liquenoides/tratamiento farmacológico , Metotrexato/uso terapéutico , Prednisolona/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Diagnóstico Diferencial , Femenino , Glucocorticoides/uso terapéutico , Humanos , Prurito , Adulto JovenAsunto(s)
Dermatosis Facial/diagnóstico , Erupciones Liquenoides/diagnóstico , Sarcoidosis/diagnóstico , Anciano de 80 o más Años , Mejilla , Diagnóstico Diferencial , Dermatosis Facial/tratamiento farmacológico , Femenino , Antebrazo , Humanos , Erupciones Liquenoides/tratamiento farmacológico , NarizRESUMEN
Checkpoint inhibitors such as pembrolizumab, an anti-PD-1 monoclonal antibody, are a promising new category of oncological therapeutics, associated with a higher risk of immune-related adverse events including dermatological, autoimmune and endocrine sequelae. Here, we present a case of a woman 76 years of age with stage IV lung adenocarcinoma who developed a severe and steroid-refractory lichenoid dermatitis associated with pruritus on pembrolizumab. This eruption resolved completely with a short course of oral cyclosporine. Cyclosporine is a promising and effective treatment option for checkpoint inhibitor-related severe cutaneous eruptions.