A case of atezolizumab‐induced photodistributed bullous pemphigoid

Leavitt, Erica; Holland, Vanessa

doi:10.1111/dth.12924

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…Reference lists of the 139 eligible articles were also screened for additional articles, and 77 articles met the eligibility criteria after screening. Among these, 70 articles reporting clinical data from 127 individual patients were reviewed to include in the analytic component of the systematic review. The 7 other articles provided predominantly summarized data, with limited and inconsistent data from individual patients.…”

Section: Resultsmentioning

confidence: 99%

Association of Bullous Pemphigoid With Immune Checkpoint Inhibitor Therapy in Patients With Cancer

et al. 2022

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IMPORTANCEThere is limited information on immune checkpoint inhibitor-induced bullous pemphigoid (ICI-BP) in patients with cancer, with most existing studies being case reports or small case series from a single institution. Prior review attempts have not approached the literature in a systematic manner and have focused only on ICI-BP secondary to anti-programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1) therapy. The current knowledge base of all aspects of ICI-BP is limited.OBJECTIVE To characterize the risk factors, clinical presentation, diagnostic findings, treatments, and outcomes of ICI-BP in patients with cancer as reported in the current literature.EVIDENCE REVIEW A systematic review was performed using PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Articles reporting data on individual patients who met preestablished inclusion criteria were selected, and a predefined set of data was abstracted. When possible, study results were quantitatively combined.FINDINGS In total, 70 studies reporting data on 127 individual patients undergoing ICI therapy for cancer (median [IQR] age, 71 [64-77] years; 27 women [21.3%]) were included. In pooled analyses, patients ranged in age from 35 to 90 years. Immune checkpoint inhibitor-induced bullous pemphigoid often occurred during the course of anti-PD-1, PD-L1, or cytotoxic T lymphocyte-associated antigen 4 therapy but was also found to develop up to several months after treatment cessation. Prodromal symptoms, such as pruritus or nonspecific skin eruptions, were found in approximately half of the patient population. Histopathologic or serologic testing, when undertaken, was a helpful adjunct in establishing diagnosis. Treatment with immunotherapy was discontinued after ICI-BP development in most patients. The most common treatments were systemic and topical corticosteroids. Steroid-sparing therapies, such as antibiotics and other systemic immunomodulators, were also used as adjuvant treatment modalities. Biologic and targeted agents, used predominantly in cases refractory to treatment with corticosteroids, were associated with marked symptomatic improvement in most patients. CONCLUSIONS AND RELEVANCEThe results of this systematic review suggest that ICI-BP often poses a therapeutic challenge for patients with cancer who are receiving immunotherapy. Further research on the early recognition, diagnosis, and use of targeted treatment modalities will be essential in developing more personalized treatment options for affected patients while minimizing morbidity and mortality.

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Section: Resultsmentioning

confidence: 99%

Association of Bullous Pemphigoid With Immune Checkpoint Inhibitor Therapy in Patients With Cancer

et al. 2022

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“…4 The most common cutaneous reactions are pruritus, nonspecific rash, vitiligo and lichenoid dermatitis. 4 Bullous dermatoses occur only in 1% of patients on anti-PD-1/PD-L1 therapy, BP being the most extended clinical form, although bullous lichenoid dermatitis and linear IgA bullous dermatoses have also been reported. [5][6][7] Unlike most immunotherapy rashes that occur early in treatment and that can be managed with topical steroids, immunotherapy-induced bullous dermatoses present characteristically with prolonged latency (average onset at 9 months) and typically require the use of systemic steroids and immunotherapy discontinuation.…”

Section: Dear Editorsmentioning

confidence: 99%

“…Immunotherapy‐related cutaneous toxicity is very common, occurring in approximately 40% of patients receiving anti‐PD‐1/PD‐L1 agents 4 . The most common cutaneous reactions are pruritus, nonspecific rash, vitiligo and lichenoid dermatitis 4 .…”

Section: Figurementioning

confidence: 99%

Epidermolysis bullosa acquisita induced by atezolizumab

Carmona‐Rocha,

Aguado,

Tubau

et al. 2023

J Deutsche Derma Gesell

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“…Immuntherapie‐assoziierte kutane Toxizität ist sehr häufig und tritt bei etwa 40% der Patienten auf, die Anti‐PD‐1/PD‐L1‐Wirkstoffe erhalten 4 . Die häufigsten kutanen Reaktionen sind Pruritus, unspezifischer Hautausschlag, Vitiligo und lichenoide Dermatitis 4 .…”

Section: Abbildungunclassified

“…[5][6][7] Im Gegensatz zu den meisten immuntherapeutischen Hautausschlägen, die zu Beginn der Behandlung auftreten und mit topischen Steroiden behandelt werden können, treten immuntherapiebedingte bullöse Dermatosen charakteristischerweise mit längerer Latenz auf (durchschnittlicher Beginn nach 9 Monaten) und erfordern typischerweise den Einsatz systemischer Steroide und das Absetzen der Immuntherapie. 4,8 Da in unserer Klinik keine Immunoblots zur Verfügung stehen, konnten wir nicht auf Autoantikörper gegen Laminin γ1 testen, was für die Unterscheidung zwischen EBA und Anti-p200-Pemphigoid interessant gewesen wäre. Die klinische Präsentation, die Befunde der DIF, die Spalthaut und die Autoantikörper gegen Kollagen VII reichten jedoch aus, um die Diagnose EBA zu bestätigen.…”

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