Dermatomyositis Flare With Immune Checkpoint Inhibitor Therapy for Melanoma

Thomas, Rachel; Patel, Herry; Scott, Joshua N.

doi:10.7759/cureus.14387

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…These scores may be skewed lower given the number of cases with cancer as a possible cause for DM. Reference lists of 114 eligible articles revealed 20 additional articles that were included. Among 134 articles, data from 165 patients were included in the systematic review (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Caravan,

Lopez,

Yeh

2024

JAMA Dermatol

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ImportanceWhile several medications are known to induce dermatomyositis (DM), most existing studies are case reports or small case series from a single institution. There is also limited information on DM induced by immune checkpoint inhibitors, which are increasingly used in oncologic therapy.ObjectiveTo characterize causes and clinical presentation of drug-induced DM based on the current literature.Evidence ReviewA systematic review was performed in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines, from inception to August 22, 2022. Articles meeting preestablished inclusion criteria (written in English and classified as original articles, case reports, literature reviews, and observation letters) were selected and data abstracted. Articles that met the scope of the review were also added from reference lists. When possible, study results were quantitatively combined.FindingsIn 134 studies (114 from the literature search and 20 additional studies pulled from reference lists) describing 165 cases, 88 patients (53.3%) were female, and the median (IQR) age was 61 (49-69) years. Among the cases of drug-induced DM, the most common associated medications were hydroxyurea (50 [30.3%]), immune checkpoint inhibitors (27 [16.4%]), statins (22 [13.3%]), penicillamine (10 [6.1%]), and tumor necrosis factor inhibitors (10 [6.1%]). Histopathologic testing, when undertaken, helped establish the diagnosis. There was a median (IQR) of 60 (21-288) days between drug initiation and drug-induced DM onset. History of cancer was reported in 85 cases (51.6%).Conclusions and RelevanceIn this systematic review, drug-induced DM was associated with multiple types of medications, including chemotherapies and immunotherapies. It is essential that dermatologists promptly recognize and diagnose drug-induced DM so that they can guide management to minimize interruption of therapy when possible.

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Section: Resultsmentioning

confidence: 99%

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Caravan,

Lopez,

Yeh

2024

JAMA Dermatol

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“…Acneiform rash/ papulopustular folliculitis [5,43,94] Dermatomyositis [95][96][97] Eruptive keratoacanthomas [98] Erythema nodosum [99][100][101] Grover's disease [102][103][104] Photosensitivity [5] Pyoderma gangrenosum [105,106] Sarcoidosis [107][108][109][110][111] Sjogren's syndrome [112] Sweet syndrome [113,114] Rosacea [115] Urticaria [5] Vasculitis [116,117]…”

Section: Less Frequently Encountered Ici-associated Iraesmentioning

confidence: 99%

Cutaneous Side Effects of Modern Targeted Therapy and Immunotherapy in Patients with Dermatological Malignancies

Plachouri

Florou

Georgiou

et al. 2023

Cancers

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The advent of immunotherapy and targeted therapies in treating dermatological malignancies has dramatically changed the landscape of dermato-oncology in recent years. Their superior efficacy compared to previous therapeutic options, such as chemotherapy, has resulted in their use in treating devastating malignancies, such as melanoma or unresectable/metastatic basal cell and squamous cell carcinoma. Skin toxicity is a critical safety consideration, among other adverse reactions, that can occur under treatment with these agents. This article aims to summarize the cutaneous side effects of immune checkpoint inhibitors and targeted dermato-oncological therapies. Although the skin side effects of these agents are primarily mild, they can occasionally affect the decision for treatment continuation and the quality of life of the affected patients. Therefore, physicians must be acquainted with the specific cutaneous toxicity profile of such treatments to mitigate their impact on the patients and optimize the overall outcome of dermato-oncological therapy.

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